Carroll W M, Mastaglia F L
Electroencephalogr Clin Neurophysiol. 1979 Jan;46(1):95-105. doi: 10.1016/0013-4694(79)90054-3.
Four patients who were rendered comatose or stuporous by drug intoxication, but who were not hypoxic, are described. Three patients received high doses of chlormethiazole for alcohol withdrawal symptoms, and one took a suicidal overdose of nitrazepam. The patient with nitrazepam overdose and two of those with chlormethiazole intoxication conformed to the criteria of 'alpha coma', showing non-reactive generalized or frontally predominant alpha activity in the EEG. The fourth patient who was unconscious after chlormethiazole administration exhibite generalized non-reactive activity in the slow beta range. All four recovered completely without neurological sequelae following the withdrawal of the offending agents. The similarities between the effects of structural lesions and pharmacological depression of the brain stem reticular formation are discussed. It is suggested that in both situations disturbed reticulo-thalamic interactions are important in the pathogenesis of alpha coma. It is concluded that when this electroencephalographic and behavioural picture is seen in drug intoxication, in the absence of significant hypoxaemia, a favourable outcome may be anticipated.
本文描述了4例因药物中毒而昏迷或昏睡但无缺氧情况的患者。3例患者因酒精戒断症状接受了大剂量的氯美噻唑治疗，1例患者过量服用硝西泮自杀。硝西泮过量患者以及2例氯美噻唑中毒患者符合“α昏迷”标准，脑电图显示为无反应性的广泛性或额叶为主的α活动。第4例患者在服用氯美噻唑后昏迷，脑电图显示为慢β波段的广泛性无反应性活动。所有4例患者在停用致病药物后均完全康复，无神经后遗症。文中讨论了结构性病变与脑干网状结构药理学抑制作用之间的相似性。研究表明，在这两种情况下，网状丘脑相互作用紊乱在α昏迷的发病机制中都很重要。得出的结论是，当在药物中毒且无明显低氧血症的情况下出现这种脑电图和行为表现时，可预期会有良好的预后。
