Shieh Andrew, Schellpfeffer Natalie
Department of Emergency Medicine, University of Michigan, Ann Arbor, MI, USA.
Department of Pediatrics, University of Michigan, Ann Arbor, MI, USA.
Case Rep Pediatr. 2022 May 30;2022:5135456. doi: 10.1155/2022/5135456. eCollection 2022.
Carbamazepine is a common anticonvulsant medication used to treat seizure disorders and is generally considered a safe medication. We describe the case of a 9-year-old female who presented with acute altered mental status and respiratory failure requiring mechanical ventilation. She was found to be intoxicated with carbamazepine through a urine drug test which was confirmed by bloodwork. After her medical condition improved, the patient admitted to self-injury through ingestion to cope with the death of a family member. She received a complete psychiatric assessment and was eventually discharged without permanent neurologic sequelae. To our knowledge, this is the first case of intentional self-injury with carbamazepine intoxication in an elementary school-aged child. When intoxication is suspected in children presenting with altered mental status, all medications available at home should be investigated. Preadolescent children may engage in nonfatal self-injury behavior, and diagnosis requires a high index of suspicion.
卡马西平是一种用于治疗癫痫疾病的常见抗惊厥药物，通常被认为是一种安全的药物。我们描述了一名9岁女性的病例，她出现急性精神状态改变和呼吸衰竭，需要机械通气。通过尿液药物检测发现她卡马西平中毒，血液检测证实了这一结果。在她的病情好转后，患者承认通过吞服药物进行自我伤害以应对家庭成员的死亡。她接受了全面的精神评估，最终出院，没有留下永久性神经后遗症。据我们所知，这是首例小学年龄段儿童故意自我伤害导致卡马西平中毒的病例。当怀疑出现精神状态改变的儿童中毒时，应调查家中所有可用药物。青春期前儿童可能会有非致命性自我伤害行为，诊断需要高度怀疑指数。
