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.
Subject(s)
Humans , Female , Aged , Ocular Motility Disorders/chemically induced , Hypoxia, Brain/chemically induced , Bupropion/adverse effects , Coma/chemically induced , Antidepressive Agents, Second-Generation/adverse effects , Drug Overdose/complications , Personality Disorders/drug therapy , Suicide , Magnetic Resonance Imaging , Fatal OutcomeABSTRACT
No abstract available.
Subject(s)
Female , Humans , Middle Aged , Anesthesia, Local/adverse effects , Anesthetics, Local/administration & dosage , Eye Movements/drug effects , Ocular Motility Disorders/chemically induced , Oculomotor Muscles/drug effects , Phacoemulsification/adverse effects , Postoperative ComplicationsABSTRACT
Oculogyric crisis which is a dystonic reaction is commonly caused by neuroleptics and rarely occurs with atypical antipsychotics specially Clozapine. In this article a case of Clozapine induced oculogyric crisis is reported. The patient was a 25-years-old woman with auditory hallucination, loosening of association and persecutory delusion that was admitted and treated. Because of poor response to typical antipsychotics, she was prescribed Clozapine. Then she experienced multiple episodes of oculogyric crisis and was treated successfully with anticholinergic medication [Artane]. In this special case, Clozapine caused oculogyric crisis. This side effect is rare but should be considered as a possible adverse effect of Clozapine. On the basis of this report, Clozapine induced oculogyric crisis may be treated successfully with Artane