ABSTRACT
Zoletil is a non-opioid, non-barbiturate animal anesthetic and proprietary combination of two drugs, a dissociative anesthetic drug, tiletamine, with the benzodiazepine anxiolytic drug, zolazepam. Zoletil has greater potency than ketamine. Zoletil is abused for recreational purposes, especially by people with easy access to medicine. However, in Korea, it is available over-the-counter. Here we report on a case of an 83-year-old woman who received injection of seven vials of "Zoletil 50" by her daughter and presented with an altered mental change. Her mental state was stupor and vital sign was hypotension, bradycardia. Her blood tests indicated metabolic and respiratory acidosis and hyperkalemia. She was treated with intravenous naloxone and flumazenil but was not responsive. She was admitted to the ICU and treated with supportive therapy. Her mental state showed transient recovery, however, her clinical manifestation worsened and she expired.
Subject(s)
Aged, 80 and over , Animals , Female , Humans , Acidosis, Respiratory , Benzodiazepines , Bradycardia , Drug Combinations , Flumazenil , Hematologic Tests , Hyperkalemia , Hypotension , Ketamine , Korea , Naloxone , Nuclear Family , Stupor , Tiletamine , Vital Signs , ZolazepamABSTRACT
We report a 39-year-old man who had newly developed a postural headache followed by a progressive decline in his level of consciousness with behavioral changes. Magnetic resonance imaging of the brain and radioisotope cisternography revealed typical findings of cerebrospinal fluid (CSF) hypovolemic syndrome combined with bilateral subdural hematoma and diencephalic compression. His headache and mental status improved after repeated epidural blood patches. Early detection of this rare complication and rapid treatment such as blood patches are very important in the treatment of these patients.
Subject(s)
Adult , Humans , Blood Patch, Epidural , Brain , Cerebrospinal Fluid , Consciousness , Headache , Hematoma, Subdural , Hypovolemia , Magnetic Resonance ImagingABSTRACT
Cerebral paragonimiasis, occurring as an extrapulmonary infestation, is one of the important intracranial lesions in Korea. We have experienced a case of multiple huge brain abscesses caused by cerebral paragonimiasis. The patient, 17 year old boy, had chief complaints of headache and vomiting followed by mental deterioration. Neurologically, the patient presented mental change, papilledema, left abducense palsy and right hemiparesis. The treatment included the closed drainage followed by total removal of abscess capsules which was confirmed histopathologically. This paper is concerned with the description of the clinical features of cerebral paragonimiasis and review of literatures.