Year: 1977
Type: article
Abstract: Vertical gaze palsy in barbiturate intoxicationParalysis of conjugate gaze is not a well-recognised sign of barbiturate intoxication in the conscious patient.1 2We describe here the occurrence of a vertical gaze palsy in a patient intoxicated with a medium-acting barbiturate. Case reportA 28-year-old Australian woman (75-5 kg) presented with a four-day history of right frontal headache, drowsiness, photophobia, ataxia, anorexia, and vomiting.She denied ingestion of drugs, other than prednisone (5 mg/ day) and theophyllin when required for her asthma, and there was no history of drug intoxication.There was no family history of adverse drug effects.She was afebrile and the general examination showed nothing abnormal.There was mild neck stiffness.She was drowsy and mildly dysarthric but could co-operate fully with the examination.There was mild engorgement of retinal veins in the right eye.Pupil size and reaction were normal.Horizontal gaze was full with bilateral fine gaze-evoked nystagmus in the supine position, which was unsustained when she sat up.Convergence was absent.Conjugate upward gaze was completely absent and no upward movement of the eyes occurred on forceful eye closure or with the oculocephalic manoeuvre.Downward gaze was full.The remainder of the examination showed nothing abnormal apart from generalised depression of deep tendon reflexes and mild ataxia of gait.
Source: BMJ
Author: L Milner
Language: English
Subfield: Emergency Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2061563897