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Abstract(s)
Introduction: An 8-year-old male child with extrapyramidal symptoms was admitted at 3 pm at the Urgency of Pediatric Hospital. Extrapyramidal syndrome (EPS), sometimes referred to as neuroleptic malignant syndrome, is a neurological side effect of antipsychotic medication characterized by a set of symptoms, that include: hyperpyrexia (an early sign of this syndrome), generalized muscle rigidity, tremors, hypersalivation, altered mental status (including catatonic signs), and evidence of autonomic dysfunction (irregular pulse or blood pressure. This child had previous Hospital admissions with similar symptoms and the possibility of a Munchausen by Proxy Syndrome (MBPS) was considered for evaluation. This syndrome is a form of child abuse in which the carer (usually the mother) simulates, manipulates or produces symptoms of illness in the victim. In most cases the detrimental effect is caused by applying foreign substances, sometimes difficult to detect in the clinical laboratories. Serum and urine samples were collected and a toxicological screening in urine was performed at the hospital by immunoassay revealing positive results for barbiturates and amphetamines. A second urine sample, collected 2 hours later, tested negative to all groups screened. The analytical results didn´t matched with clinical disturbances of the patient and further diagnosis procedures yielded no pathological findings. The serum and urine samples were sent to the Department of Chemistry and Forensic Toxicology of National Institute of Legal Medicine and Forensic Sciences (INMLCF) for an extensive screening for drugs and medicines.
Description
Poster apresentado na TIAFT 2013 - The 51st Annual Meeting of The International Association of Forensic Toxicologists, Funchal (Portugal), 2013
Keywords
Munchausen by proxy Haloperidol Extrapyramidal syndrome