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Michael Salcman, MD; Charles E. Pippenger, PhD
Columbia University College of Physicians and Surgeons New York

JAMA. 1975;231(9):915.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

We are presenting a case of encephalopathy secondary to a massive overdose of carbamazepine (Tegretol). The clinical picture is nonspecific and may be confused with the postictal state in those patients who have access to this anticonvulsant.

Report of a Case.—

A 16-year-old boy was brought to the Neurological Institute after having failed to recover from a presumed psychomotor seizure. The patient had suffered three previous episodes in the preceding year and therapy had recently been started with carbamazepine, 200 mg twice daily. On admission, the patient was seen in profound stupor. He neither responded to speech nor made spontaneous vocalizations. Minimal painful stimuli would elicit semipurposeful movements of the extremities. Strength, tone, and deep tendon reflexes appeared to be unimpaired. Examination of the cranial nerves showed normal fundi, brisk corneal reflexes, and normal pupillary responses. Nevertheless, biplanar disconjugate gaze (skew deviation) and an absent response to . . . [Full Text PDF of this Article]

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