Résumé
A 51-year-old woman with schizophrenia and depression brought to our emergency room after thioridazine overdose. Her mental state was semicomatous. The initial electrocardiogram showed bradycardia, atrial premature contractions, prolonged PR interval, wide QRS complexes and U waves. She was admitted to the intensive care unit. Continuous electrocardiographic monitoring and artificial ventilation was performed. The treatment included fluids hydration, administration of inotropic agents, alkalization and replacement of electrolytes. On day 2, torsades de pointes on the electrocardiogram was occurred. The rhythms were resolved with isoproterenol infusion. Her hemodynamic state became stable. On day 6, electrocardiographic finding was normalized. She was recovered without any neurologic or cardiac complications. Herein, a rare case is reported, with the review of the literature.
Sujets)
Femelle , Humains , Adulte d'âge moyen , Troubles du rythme cardiaque , Bradycardie , Dépression , Électrocardiographie , Électrolytes , Service hospitalier d'urgences , Hémodynamique , Unités de soins intensifs , Isoprénaline , Intoxication , Schizophrénie , Thioridazine , Torsades de pointes , VentilationRésumé
Posterior reversible encephalopathy syndrome (PRES) is characterized by headache, vomiting, confusion, and seizure. In addition, PRES is associated with reversible bilateral cortical and subcortical edema on occipital lobe or parieto-occipital lobe. Eclampsia is a rare condition to pregnant and puerperal women and one of common causes of the PRES. The clinical and radiologic manifestations can be resolved without irreversible complication by early diagnosis and appropriate treatment. The authors report a case of eclamptic encephalopathy associated with PRES, in which an 18-year-old woman had clinical manifestations of visual disturbance, headache, and tonic-clonic seizure at 34 hours after vaginal delivery. High signal intensities are seen in both parieto-occipital lobes and left basal ganglia on fluid attenuated inversion recovery (FLAIR) images and T2 weighted images performed at emergency room. But no significant signal change in both parieto-occipital lobes on diffusion weighted images (DWI). Because seizure was repeated, then anticonvulsant was administered at intensive care unit. On the second day, the clinical manifestations were resolved as blood pressure was normalized. The FLAIR imaging and DWI sequences can play an important role in the diagnosis of PRES.