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The Journal of the Royal Society for the Promotion of Health
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Lessons to be learned: a case study approach

Hyperactivity and confusion in the presentation of hyoscine overdose

Naeen Ayub

Staff Grade Paediatrician Royal Shrewsbury Hospital Shrewsbury

David Donaldson

Consultant Chemical Pathologist Department of Chemical Pathology East Surrey Hospital Redhill

Derek Bedford

Department of Chemical Pathology East Surrey Hospital

Ruth Alloway

Child and Family Consultation Service East Surrey Hospital

Michael Ryalls

Department of Paediatrics Royal Surrey County Hospital, Guildford

The case report is presented of a ten-and-a-half year old boy with acute onset of confusion and visual hallucinations, subsequently confirmed to be due to hyoscine toxicity following ingestion of over-the-counter (OTC) travel sickness tablets. It is suggested that packs of such pills should carry a prominent cautionary label. A clear clinical history is very important - not only in aiding the differentiation of acute viral infections involving the central nervous system (such as acute encephalitis) from drug toxicity, but also in rationalising any further diagnostic investigations. The possible underlying reasons for drug ingestion in this case are discussed.

Key Words: Confusion • denial • hyoscine • hyperactivity • poisoning

The Journal of the Royal Society for the Promotion of Health, Vol. 117, No. 4, 242-244 (1997)
DOI: 10.1177/146642409711700409
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