Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, Basel, Switzerland
Intensive Care Unit, Department of Acute Medicine, University Hospital Basel, Basel, Switzerland.
BMJ Case Rep. 2023 Oct 6;16(10):e257391. doi: 10.1136/bcr-2023-257391.
Patients with brain death have by definition irreversible and complete loss of brainstem reflexes. Before a definite diagnosis of brain death can be confirmed, all potential confounders must be thoroughly excluded. Baclofen intoxication is a rare cause of brain death mimic characterised by transient deep coma and absence of brainstem reflexes and might be mistaken with brain death. We report the case of a female patient in her 70s who ingested baclofen with suicidal intent and was admitted with a deep coma and loss of all brainstem reflexes and a spontaneous burst-suppression pattern in the electroencephalography which resolved over 10 hours. After a state mimicking brain death for 6 hours, the patient experienced complete recovery. Severe baclofen intoxication can mimic brain death clinically and is associated with temporary pathological electroencephalographic findings. Awareness of this toxidrome is crucial, as appropriate management can lead to full recovery.
脑死亡患者的定义为脑干反射不可逆转且完全丧失。在明确诊断脑死亡之前，必须彻底排除所有潜在的混杂因素。巴氯芬中毒是一种罕见的脑死亡模拟原因，其特征为短暂的深度昏迷和脑干反射消失，可能与脑死亡相混淆。我们报告了一例 70 多岁的女性患者，她有意服下巴氯芬并被送进医院，当时处于深度昏迷，丧失了所有的脑干反射，脑电图呈现自发的爆发抑制模式，该模式在 10 小时内消失。在出现脑死亡模拟状态 6 小时后，患者完全恢复。严重的巴氯芬中毒可能在临床上模拟脑死亡，并伴有暂时的病理性脑电图发现。了解这种中毒综合征至关重要，因为适当的治疗可以导致完全恢复。
