Supraversión de la mirada en intoxicación mortal por bupropión

Autores/as

  • Luis Cartier R Universidad de Chile
  • Cristian Romero O Universidad de Chile
  • Gerardo Pérez P Universidad de Chile

Palabras clave:

Bupropion, Coma, Hypoxia, Leukoencephalopathies

Resumen

Upgaze or sustained elevation of the eyes, is an alteration of ocular motility initially described in hypoxic coma. We report a 65-year-old woman admitted with hypotension and alteration of sensorium due to the ingestion of 9.5 g of Bupropion. She presented two seizures of short duration, without epileptic activity on the EEG. She had a persistent asynchronous myoclonus in extremities, tachycardia and prolonged Q-t. She suffered a cardiac arrest caused by asystole, which recovered quickly in five minutes. At that moment, upgaze appeared, associated with a persistent ocular opening, which persisted for days, but finally disappeared, without remission of coma. A magnetic resonance imaging done at the eighth day, showed hyperintensity of the oval center and corpus callosum which disappeared in a new imaging study done 30 days later, where images of hypoxia in the basal nuclei and cortex appeared. The patient died forty seven days after admission. Up-gaze is an ominous oculomotor alteration linked to an important but incomplete damage in the cerebral cortex, a condition that perverts some sequences of the ocular opening, reversing the Bell phenomenon and producing eyelid retraction.

Biografía del autor/a

Luis Cartier R, Universidad de Chile

Profesor Titular Departamento de Ciencias Neurológicas Oriente, Facultad de Medicina Universidad de Chile. Servicio de Neurología, Hospital del Salvador, Santiago, Chile

Cristian Romero O, Universidad de Chile

Becario neurología Departamento de Ciencias Neurológicas Oriente, Facultad de Medicina Universidad de Chile. Servicio de Neurología, Hospital del Salvador, Santiago, Chile

Gerardo Pérez P, Universidad de Chile

Becario neurología Departamento de Ciencias Neurológicas Oriente, Facultad de Medicina Universidad de Chile. Servicio de Neurología, Hospital del Salvador, Santiago, Chile

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Publicado

2018-05-29

Cómo citar

Cartier R, L., Romero O, C., & Pérez P, G. (2018). Supraversión de la mirada en intoxicación mortal por bupropión. Revista Médica De Chile, 146(5). Recuperado a partir de https://revistamedicadechile.cl/index.php/rmedica/article/view/6311

Número

Sección

Reporte de Caso Clínico

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