POST ICTAL HAPPINESS

Abstract

1) Introduction

Amphetamine poisoning is rare in pediatric age group and is an uncommon presentation at the Emergency Department. It is a diagnostic challenge during the early presentation, especially in the younger age group.

2) Case Report

We report a case of 1-year 5-months old infant with acute amphetamine poisoning due to accidental ingestion. She was initially referred to our Emergency Department as a Meningitis case in view of fitting episode that was associated with fever.  On examination, child was hyperactive, smiling, and doesn’t show any sign of post ictal drowsiness or meningism despite having high grade temperature and tachycardia. After frequent questioning from the family member, mother gave the history that child went out from the house with the sister and drank something from a random bottle in the park. This part of the history suggested possible of toxic substance involvement hence urine toxicology was done, which conformed presence of amphetamine. Patient was admitted to pediatric ward for supportive therapy with sedation (benzodiazepine) and observation. She was later discharge home after showing no life-threatening signs and symptoms.

3) Discussion and Conclusion

Presence of sympathomimetic toxidrome which were hyperactivity, hyperthermia, tachycardia and hypertension helps us in treating an unknown substance poisoning.

To make it more challenging, pediatric age group usually didn’t come with a classical presentation, thus history taking is the key in solving the puzzle. This case highlights the importance of high index of suspicion in regards to the clinical presentation and the ability to obtained a detailed history which is of utmost importance as with any other type of overdose or poisoning.