We report the case of a 62-year-old woman treated for personality and mood disorders, with a history of two suicide attempts.
In February 2017, 9.5 g clover was ingested, 1.5 g chlorprom, and two glasses of wine.
The relatives found her altered and gave her to the Hospital del Niño, where she was admitted with consciousness compromised in Glasgow 10, blood pressure 90/60, tachyarlic acid with 115dlm, electrocardiogram QT segment (52.6 mg/t).
Within the first 24 hours of admission she had two brief episodes of seizures, 30 seconds and less than a minute.
Electroencephalogram (EEG) showed low voltage delta-theta activity, with no signs of epilepsy.
Unenhanced brain CT was normal.
The patient had scald reactivity and remained altered consciousness, with generalized myoclonus and involuntary movements of the extremities; increased muscle tone, osteotendinous reflexes and polykinetic plantar reflexes (TRO).
On the morning of the third day she suffered cardiorespiratory arrest due to asystole, received immediate resuscitation, intubation, after 5 min of spontaneous cardiac activity.
The next day she had unconscious minds of myoclonus, and maintained persistent narrowing of the eyelid with little eyelash and abnormal overelevation of the eyes, as looking back.
The pupils were equal and reactive to light, with preserved oculocephalic reflexes.
His extremities were hypotonic and had TOR exhaled with bilateral Babinski.
Nociceptive stimuli elicited extensor responses of the four limbs and a simulated ectoparasite, with descent of the ocular globe, which in the reperforation a elevabotebral volviated.
The phenomenon was repeated with any stimulus.
Brain MRI performed on the eighth day showed hyperintense images of the white matter of the oval center and corpus callosum in the diffusion and FLAIR sequence showed hypoxic areas with hypoxic basal ganglia.
The supraversion of the gaze was maintained at least ten days, then the gaze became central, while the patient remained in coma and without variations after one month.
Pupils remained the same in response to light and preserved oculocephalic reflexes, OTRs were alive with extensor plantar reflexes.
Nociseptive stimuli continued to generate extensor responses.
The EEG was practically flat.
Control MRI showed a defined cerebral palsy with hyperintensity in the basal ganglia and in different areas of the cerebral and cerebellar cortex.
There was white substantia hyperintensity.
The patient died 47 days later.
