Supraversión de la mirada en intoxicación mortal por bupropión / Sustained upgaze in a patient who ingested high doses of bupropion: report of one case
Rev. méd. Chile
; 146(5): 665-669, mayo 2018. graf
Article
in Es
| LILACS
| ID: biblio-961444
Responsible library:
CL1.1
ABSTRACT
Upgaze or sustained elevation of the eyes, is an alteration of ocular motility initially described in hypoxic coma. We report a 65-year-old woman admitted with hypotension and alteration of sensorium due to the ingestion of 9.5 g of Bupropion. She presented two seizures of short duration, without epileptic activity on the EEG. She had a persistent asynchronous myoclonus in extremities, tachycardia and prolonged Q-t. She suffered a cardiac arrest caused by asystole, which recovered quickly in five minutes. At that moment, upgaze appeared, associated with a persistent ocular opening, which persisted for days, but finally disappeared, without remission of coma. A magnetic resonance imaging done at the eighth day, showed hyperintensity of the oval center and corpus callosum which disappeared in a new imaging study done 30 days later, where images of hypoxia in the basal nuclei and cortex appeared. The patient died forty seven days after admission. Up-gaze is an ominous oculomotor alteration linked to an important but incomplete damage in the cerebral cortex, a condition that perverts some sequences of the ocular opening, reversing the Bell phenomenon and producing eyelid retraction.
Key words
Full text:
1
Index:
LILACS
Main subject:
Ocular Motility Disorders
/
Hypoxia, Brain
/
Bupropion
/
Coma
/
Antidepressive Agents, Second-Generation
/
Drug Overdose
Limits:
Aged
/
Female
/
Humans
Language:
Es
Journal:
Rev. méd. Chile
Journal subject:
MEDICINA
Year:
2018
Type:
Article