BROMIDE INTOXICATION AND ELECTROSHOCK THERAPY.
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The authors warn physicians that intoxication by Angel's Trumpet (Datura sauveolens) is becoming more frequent due to its use by adolescents and young adults as a legal, readily available hallucinogen. Ingestion of Angel's Trumpet flowers or a tea brewed from them results in an alkaloid-induced central nervous system anticholinergic syndrome characterized by symptoms such as fever, delirium, hallucinations, agitation, and persistent memory disturbances. Severe intoxication may cause flaccid paralysis, convulsions, and death. Treatment with intravenous physostigmine reverses the toxic effects of Angel's Trumpet.
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Ten patients presented with acute anticholinergic syndrome secondary to Jimson seed (Datura stramonium) ingestion. Six of the 10 patients required hospitalization because of hyperpyrexia and severe neurologic derangement. Electroencephalograms recorded immediately after admission showed [1] slow wave activity, and [2] bizarre rhythmical bursts of high-voltage sharp wave activity; both of which rapidly resolved during the next 24 hours, as did the associated clinical findings of hyperreflexia, bilateral dorsiflexor Babinski responses, and decerebrate posturing. Previously unreported elevation of serum glutamic-oxalacetic transaminase and lactic dehydrogenase and prothrombin time prolongation are documented. The pathogenic mechanism accounting for abberation of these laboratory values remains undefined. All patients showed rapid clinical improvement; follow-up neurologic evaluation and electroencephalograms have been within normal limits. Because of the widespread availability and potential abuse of the Jimson seed, the clinical syndrome associated with its toxicity merits recognition.
A case of a psychosis induced by ingestion of blossoms of the solanum Brugmansia insigniis is presented. This plant is used by young persons as a hallucinogenic drug. The psychopathology of this kind of intoxication has not been documented in the literature up to now. It is characterized by anticholinergic effects (e.g. mydriasis), disturbances of orientation, incoherent thoughts, flight of ideas, tangential thinking illusions, auditory hallucinations (e.g. verbal hallucinations), visual hallucinations and affective lability. In addition to hyoscine (scopolamine) and atropine, hallucinogenic effects may be related to previously identified alkaloids.
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