Citation

Kansal A, Khan FA, Rana MH. Critical Care and Shock 2017; 20(1): 17-20.

Copyright

(Copyright © 2017)

DOI

unavailable

PMID

unavailable

Abstract

We present a case of "complete" loss of brain stem reflexes following amitriptyline overdose, which mimicked brain death. This case high- lights the complexities associated with clinical brain death determination and calls for close attention to details. Based on previously published case reports, we analyse the relationship with the amitriptyline dose, blood level and timing of neurological recovery. Ours is the fourth case report in literature demonstrating "complete" loss of brain stem reflexes following amitriptyline overdose. The amount of amitriptyline ingested in these cases (including our case report) ranged from 500 mg to 9 g; the blood concentrations ranged from 1.35 microgram/ml to 3.43 microgram/ml. The neurological recovery seems to start by day two to four with complete neurological recovery by day five to seven. © 2017, Indonesian Society of Critical Care Medicine. All rights reserved.

Language: en

Keywords

Amitriptyline toxicity; Brain death; Brain stem reflexes