Neurological findings in a case of coma secondary to <i>Datura stramonium</i> poisoning

Parissis, Dimitrios; Mellidis, C.; Boutis, Anastasios; Apostolidis, K.; Ignatiadis, M.; Kiosses, Vassilios G.; Milonas, I.

doi:10.1046/j.1468-1331.2003.00614.x

Cited by 19 publications

(7 citation statements)

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“…In our opinion, these are characteristic features that counteract the intoxication. The nervous signs (disturbances in locomotion, hyperaesthesia, hyperreflexia and tremor, correlating with meningeal hyperaemia) observed by us as well as other investigators 11,21,29,33,42 is in accordance with the well-known CNS signs due to these alkaloids.…”

Section: Discussionsupporting

confidence: 90%

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Clinical and pathological studies on intoxication in horses from freshly cut Jimson weed (Datura stramonium)-contaminated maize intended for ensiling : clinical communication

Binev¹,

Valchev²,

Nikolov³

2006

J. S. Afr. Vet. Assoc.

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Spontaneous intoxication in 34 horses after ingesting freshly harvested maize that was to be used for ensiling and heavily contaminated with young Datura stramonium plants, is described. The clinical status of all horses was monitored for 7 days, and included body (rectal) temperature, respiratory and heart rates, colour and moistness of visible mucosae, changes in pupil size, appetite, thirst, general behaviour, locomotion, sensory perceptions, urination and defaecation. The intoxication was accompanied by altered clinical status, namely mild hyperthermia, tachycardia, polypnoea, dyspnoea and shallow breathing, mydriasis, dry oral, rectal, vaginal and nasal mucosae, acute gastric dilatation and severe intestinal gas accumulation, anorexia to complete refusal of feed, decreased or absent thirst, absence of defaecation and urination. As a result of the treatment, the clinical parameters normalised between days 2 and 5. Necropsies and pathological studies were performed on two horses that died, revealing toxic liver dystrophy, cardiac lesions and substantial dystrophic and necrotic processes in the kidneys. The observed clinical signs, the pathomorphological changes and the applied therapy could be used in the diagnosis, differential diagnosis, prognosis and treatment of Jimson weed intoxication.

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Section: Discussionsupporting

confidence: 90%

“…Poisoning results in widespread inhibition of parasympathetic innervated organs 7,15,20,35,40 . The wide distribution, high toxicity and the potential for occurrence in foodstuffs are responsible for the numerous incidents in humans [1][2][3]6,7,[9][10][11][12][14][15][16]18,19,21,25,30,[32][33][34][35]38,41,42 .…”

Section: Introductionmentioning

confidence: 99%

Clinical and pathological studies on intoxication in horses from freshly cut Jimson weed (Datura stramonium)-contaminated maize intended for ensiling : clinical communication

Binev¹,

Valchev²,

Nikolov³

2006

J. S. Afr. Vet. Assoc.

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“…Long-term consumption of Datura (around 3 to 4 seeds throughout the day with a maximum intake of 6 seeds/day over a period of 3 years) resulted in the onset of paranoid schizophrenia, an altered state of consciousness and aggressive behaviour [ 63 ]. Finally, even fatalities related to the intake of Datura stramonium were reported, mainly due to its accident consumption [ 64 - 66 ].…”

Section: Resultsmentioning

confidence: 99%

Herbal Highs: Review on Psychoactive Effects and Neuropharmacology

Graziano

Orsolini

Rotolo

et al. 2017

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Background: A new trend among users of new psychoactive substances’ the consumption of “herbal highs”: plant parts containing psychoactive substances. Most of the substances extracted from herbs, in old centuries were at the centre of religious ceremonies of ancient civilizations. Currently, these herbal products are mainly sold by internet web sites and easily obtained since some of them have no legal restriction.Objective: We reviewed psychoactive effects and neuropharmacology of the most used “herbal highs” with characterized active principles, with studies reporting mechanisms of action, pharmacological and subjective effects, eventual secondary effects including intoxications and/or fatalitiesMethod: The PubMed database was searched using the following key.words: herbal highs, Argyreia nervosa, Ipomoea violacea and Rivea corymbosa; Catha edulis; Datura stramonium; Piper methysticum; Mitragyna speciosa.Results: Psychoactive plants here reviewed have been known and used from ancient times, even if for some of them limited information still exist regarding subjective and neuropharmacological effects and consequent eventual toxicity when plants are used alone or in combination with “classical” drugs of abuse.Conclusion: Some “herbal highs” should be classified as harmful drugs since chronic administration has been linked with addiction and cognitive impairment; for some others taking into consideration only the recent trends of abuse, studies investigating these aspects are lacking.

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“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] The preponderance of the publications are case reports that describe the abuse of Datura for its psychoactive properties and the development of a classical anticholinergic toxidrome. The purpose of this review is to provide the reader with a succinct overview of selected issues that are associated with exposure to Datura -specifically unintentional and intentional exposure to any part of the plant.…”

Section: Introductionmentioning

confidence: 99%

Aspects ofDaturapoisoning and treatment

Krenzelok

2010

Clinical Toxicology

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Introduction. Datura species, especially Datura stramonium (e.g., jimsonweed), are the focus of scores of case reports that chronicle the toxidrome of anticholinergic toxicity. Mechanisms of toxicity. Toxicity occurs because of the presence of up to 28 belladonna alkaloids, predominated by atropine and scopolamine. There are significant interspecies differences in the ratio of the belladonna alkaloids, atropine to scopolamine, and the presence of at least 26 other related alkaloids will vary, even between and among specimens of the same species. The differences may account for unexpected dose-response effects that are observed in some patients and even different profiles of toxicity. All parts of the Datura species contain belladonna alkaloids; in decreasing order, the belladonna alkaloid content is generally the greatest in the petioles (flowers), stem, fruit (seeds), leaves, and roots. Features. The most prominent symptoms are due to the blockade of peripheral muscarinic receptors that innervate exocrine glands, smooth muscle, and cardiac tissue. Therefore, the primary toxic manifestations include mydriasis, which is due to the blockade of papillary sphincter muscle and iris muscle; dry mouth, secondary to parasympathetic blockade of salivary secretion; tachycardia, caused by competition at muscarinic receptors in postganglionic parasympathetic neurons and blockade of receptors in the SA node; and fever and erythema, because of vasodilation and inhibition of sweating. Direct ocular exposure. Well known to produce mydriasis after ingestion, Datura is also notorious for producing maladies such as "gardeners eye" and "cornpickers eye," which is a testament to the high concentrations of belladonna alkaloids in the entire plant. When the sap or dried plant material from a member of the Datura species enters the eye directly, the papillary sphincter and ciliary muscles are affected resulting in mydriasis and cycloplegia. Pupil dilation is sudden in onset and often profound. In a dose-response fashion, the mydriasis and its persistence will be dependent on the alkaloidal content and quantity of the sap. The mydriasis can be bilateral, but most commonly it is unilateral, which is frightening to the victim and to the clinician and suggestive of significant cerebral pathology. Management. As with any toxic exposure, the foundation of patient management is supportive care and patient reassurance. Because of the central nervous system effects of the belladonna alkaloids, the patient may be agitated, combative, confused, and disoriented. Initial intervention focuses on addressing those issues that protect the patient and their caregivers. In severe cases, physostigmine, a cholinesterase inhibitor, should be used to reverse anticholinergic toxicity. Physostigmine should be given intravenously to an adult in a dose of 0.5-2.0 mg at a rate of no more than 1 mg/min; a second dose may be administered if necessary. Children should receive 0.02 mg/ kg intravenously and the rate should not exceed 0.5 mg/min. Extracorporeal eliminat...

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Neurological findings in a case of coma secondary to Datura stramonium poisoning

Cited by 19 publications

References 1 publication

Clinical and pathological studies on intoxication in horses from freshly cut Jimson weed (Datura stramonium)-contaminated maize intended for ensiling : clinical communication

Clinical and pathological studies on intoxication in horses from freshly cut Jimson weed (Datura stramonium)-contaminated maize intended for ensiling : clinical communication

Herbal Highs: Review on Psychoactive Effects and Neuropharmacology

Aspects ofDaturapoisoning and treatment

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