[Sudden coma in a 20-year-old man]. 2000

R Herbrand, and P Greminger, and G Schurter, and W Pletscher, and H Kupferschmidt
Departement für Innere Medizin, Medizinische Poliklinik, Universitätsspital Zürich.

A 20-year-old male patient was brought to the emergency department by Emergency Medical Services after having been found unconscious. Upon arrival the patient was comatose with a GCS of 3, his vital signs were stable (with blood pressure 100/54 mmHg, heart rate 48 per minute, respiration rate 12 per minute and oxygen saturation 98% on room air). Both pupils were 3 mm, symmetric, and only minimally responsive. Approximately 2 hours after arrival the patient awoke and admitted having taken three ampoules of GHB (gamma hydroxybutyrate). GHB is a synthetic analog of gamma-amino butyric acid (GABA), a centrally inhibitory neurotransmitter. While GHB produces euphoria in low doses, small overdosing can result in severe poisoning with coma. The combination with other CNS depressants such as alcohol, opioids, and other narcotics is particularly dangerous. Physicians should be alerted to the clinical effects of GHB since abuse has become more widespread in Switzerland within the last months. In patients with unexplained coma the differential diagnosis of GHB-intoxication should be taken into consideration.

UI MeSH Term Description Entries
D008297 Male Males
D003128 Coma A profound state of unconsciousness associated with depressed cerebral activity from which the individual cannot be aroused. Coma generally occurs when there is dysfunction or injury involving both cerebral hemispheres or the brain stem RETICULAR FORMATION. Comatose,Pseudocoma,Comas,Pseudocomas
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D004630 Emergencies Situations or conditions requiring immediate intervention to avoid serious adverse results. Emergency
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000328 Adult A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available. Adults
D012978 Sodium Oxybate The sodium salt of 4-hydroxybutyric acid. It is used for both induction and maintenance of ANESTHESIA. 4-Hydroxybutyrate Sodium,Oxybate Sodium,Sodium Oxybutyrate,Sodium gamma-Hydroxybutyrate,gamma-Hydroxybutyrate,Somsanit,Xyrem,4 Hydroxybutyrate Sodium,Oxybate, Sodium,Oxybutyrate, Sodium,Sodium gamma Hydroxybutyrate,gamma Hydroxybutyrate
D062787 Drug Overdose Accidental or deliberate use of a medication or street drug in excess of normal dosage. Drug Overdoses,Overdose, Drug,Overdoses, Drug

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