Seizures caused by ingestion of Atropa belladonna in a homeopathic medicine in a previously well infant: case report and review of the literature.

Atropa belladonna is a poisonous plant that can cause anticholinergic effects when ingested. Roots, leaves, and fruits of the plant contain the alkaloids atropine, hyoscyamine, and scopolamine, which can lead to an anticholinergic toxidrome; however, not all characteristics of the toxidrome are necessarily present in each case of poisoning. We present an infant who suffered serious seizures after ingestion of a homeopathic agent containing A. belladonna. The 20-day-old infant arrived at the emergency department with fever and generalized seizures for 30 minutes, 2 hours after ingesting the correct dose of a homeopathic medication agent used for infantile colic. The patient was treated with intravenous benzodiazepines and antibiotics after a full sepsis work up; all the laboratory results were normal and the fever resolved after several hours. The infant recovered fully with normal neurological function and a normal electroencephalogram. This infant probably manifested what is known as the central anticholinergic syndrome. We discuss his presentation and review of the literature on this topic.

The ocular disease of Aristodemus and Eurytus 480 BC: diagnostic considerations.

OBJECTIVE: In the historic description of Herodotus on the battle of Thermopylae at 480 BC two formerly healthy warriors suffer from "ophthalmia". The purpose of this study is to assess the possible aetiologies of this disease. DESIGN: We studied Herodotus' description in translation and offer a differential diagnosis. RESULTS: From the text we deduced that the "ophthalmia" was a condition in two physically fit males with a bilateral decreased or distorted vision, lasting longer than an hour, with an acute or subacute onset in Ancient Greece. The condition ultimately went into remission in one of the two patients, whereas the other subject deceased in combat not long after the onset of the disease, still suffering from the disease. The differential diagnosis consists of (1) anticholinergic syndrome secondary to an intoxication with the berries of the plant Atropa belladonna, (2) automutilation and (3) psychogenic loss of visual acuity. CONCLUSION: It is impossible to assess the ultimate cause of the "opthalmia" after 2500 years, but we suggest the anticholinergic syndrome by intoxication with Atropa belladonna is the most likely.

Acute anticholinergic syndrome from Atropa belladonna mistaken for blueberries.

PURPOSE: To report the first case in the ophthalmic literature of acute anticholinergic syndrome after ingestion of Atropa belladonna mistaken for blueberries. METHODS: A 36-year-old woman presented to our ophthalmic emergency department with complaints of blurry vision, lightning flashes, disorientation, loss of balance, agitation, and anxiety for 24 hours. Ophthalmic examination revealed bilateral pupillary dilatation and paresis of accommodation. Additional symptoms of the anticholinergic syndrome were elicited on further questioning. RESULTS: Anticholinergic intoxication was suspected and the patient admitted to have eaten six "blueberries" found in the forest the previous day. The patient identified Atropa belladonna as the source of the berries she had eaten when shown photographs of the plant and its fruit. The recommendations of the Swiss Toxicological Information Centre were followed and physostigmine, the antidote for severe poisoning when 10 or more berries are ingested, was not administered. CONCLUSIONS: Accidental ingestion of Atropa belladonna berries may cause patients to first consult an ophthalmologist. It is important to recognize the anticholinergic syndrome caused by such intoxication in order to make a proper diagnosis, avoid unnecessary testing, and provide expedient appropriate treatment when required.

Accidental overdose in the deep shade of night: a warning on the assumed safety of 'natural substances'.

There is an increasing use of herbal remedies and medicines, with a commonly held belief that natural substances are safe. We present the case of a 50-year-old woman who was a trained herbalist and had purchased an 'Atropa belladonna (deadly nightshade) preparation'. Attempting to combat her insomnia, late one evening she deliberately ingested a small portion of this, approximately 50 mL. Unintentionally, this was equivalent to a very large (15 mg) dose of atropine and she presented in an acute anticholinergic syndrome (confused, tachycardic and hypertensive) to our accident and emergency department. She received supportive management in our intensive treatment unit including mechanical ventilation. Fortunately, there were no long-term sequelae from this episode. However, this dramatic clinical presentation does highlight the potential dangers posed by herbal remedies. Furthermore, this case provides clinicians with an important insight into potentially dangerous products available legally within the UK. To help clinicians' understanding of this our discussion explains the manufacture and 'dosing' of the A. belladonna preparation.

Lessons to be learned: a case study approach. Unseasonal severe poisoning of two adults by deadly nightside (Atropa belladonna).

Unseasonal, mid-winter, severe poisoning by deadly nightshade is reported in two adults who simultaneously ate from a pie made of frozen deadly nightshade berries, mistaken at the time of picking for bilberries. Atropine levels are reported in the urine. Physostigmine treatment was ineffective.

[Fever, large eyes and confusion; the anticholinergic syndrome]. / Koorts, grote ogen en verwardheid; het anticholinergisch syndroom.

A 52-year-old woman was in a confused state and had difficulty walking and swallowing, as well as dysarthria. That same day she had consumed some berries, which she thought were bilberries, but she had instead eaten Atropa belladonna (deadly nightshade). She made a spontaneous and full recovery within a few days. A 3-year-old boy, with amblyopia, was vomiting, had difficulty walking and had a temperature of 39 degrees C. He was agitated and had a warm, red skin and dilated pupils that did not respond to light. A suspected intoxication with a parasympathicolytic agent was confirmed upon an empty bottle of atropine eye drops being found at his home. The boy made a full recovery following treatment with physostigmine. It is important to consider an anticholinergenic intoxication in the case of patients who are confused, have difficulty speaking, large fixed pupils and fever. A specific anamnesis with respect to medicines, eye drops and berries or plants consumed can confirm the diagnosis. It is important to recognise an anticholinergic intoxication because without treatment, the outcome can be fatal.

Atropa belladonna intoxication: a case report.

Atropa belladonna is a poisonous plant also called deadly nightshade. Its roots, leaves and fruits contain alkaloids: atropine, hyocyamine and scopolamine. The risk of poisoning in children is important because of possible confusion with other berries. Atropa belladonna acute intoxication is a severe condition, it's should be considered in the presence of anti-cholinergic toxidrome, the differential diagnosis include other plants or psychoactive drugs containing atropine. The treatment is mainly symptomatic including gastrointestinal decontamination with activated charcoal. In severe cases, physostigmine can be used as an antidote. We report the case of 11 year old girl with Atropa belladonna poisoning which was administrated in a therapeutic purpose as a remedy to jaundice. The child presented essentially a central anti-cholinergic syndrome. She was admitted in the intensive care unit, the progression was favorable with symptomatic treatment.

[Deadly nightshade (Atropa belladonna) intoxication in a 2-year-old child]. / Un cas d'intoxication aiguë par la belladone (Atropa belladona) chez une enfant de 2ans.

Plant intoxications account for 5% of all intoxication cases according to French anti-poison centers. We report an uncommon case of intoxication with deadly nightshade (Atropa belladonna) in a 2-year-old child. The child presented at the ER with an atropinic syndrome, both central and peripheral, after ingestion of wild berries a few hours before. The fruit and leaves brought in by the mother allowed the anti-poison center to identify belladonna, in agreement with clinical findings. The child was kept in the intensive care unit for 48 h and progression was favorable with symptomatic treatment.

An Atropa belladonna L. poisoning with acute subdural hematoma.

Atropa belladonna L. is a plant long known to cause poisoning. But no cases of acute subdural hematoma resulting from such poisoning have been reported so far. Care must also be taken in terms of acute pancreatitis and rhabdomyolysis in cases of such poisoning. The plant may sometimes be mistaken for the Caucasian blueberry, V. arctostaphylos L. At least one anti-cholinesterase toxidrome finding was determined in all the nine cases of belladonna poisoning in this series. No elevated creatine kinase was reported in one case with acute subdural hematoma and hyperamylasemia.