Rinsho Shinkeigaku (Clinical Neurology)

Case Report

Acute encephalopathy due to angel's trumpet intoxication:A case report and literature review

Shinichi Takeshima, M.D.1), Shuichiro Neshige, M.D.1)2), Naoyuki Hara, M.D.1)3), Tomoshi Kubo, M.D.1)3), Takahiro Himeno, M.D.1) and Masaru Kuriyama, M.D., Ph.D.1)

1)Department of Neurology, Brain Attack Center Ota Memorial Hospital
2)Present Address: Department of Neurology, Kyoto University Graduate School of Medicine
3)Present Address: Department of Clinical Neuroscience and Therapeutics, Hiroshima University Graduate School of Biomedical & Health Sciences

We report two cases (a married couple) of intoxication due to angel's trumpet ingestion. Case 1: A 71-year-old woman was found lying unconscious on the sofa at home and was brought to our hospital by ambulance. She showed mydriatic anisocoria, and an intracerebral lesion was suspected. However, the brain magnetic resonance imaging showed no abnormal lesion and acute encephalopathy of unknown cause was diagnosed. Case 2: A 68-year-old man (husband of the patient of Case 1) showed alteration of consciousness with agitation and was admitted to our hospital on the next day. He also had slight mydriasis. As his manifestations were similar to those of his wife, we studied their medical history again. We found that they mistook the roots of angel's trumpet for burdock and cooked and ate them. This intoxication causes characteristic encephalopathy with altered consciousness and mydriasis. In the case of anisocoria or mild mydriasis, the diagnosis is difficult sometimes. The intoxication occurred within a family; this was a clue to the correct diagnosis. Severe cases exhibit pyramidal signs and symptoms or convulsion, and deaths have been reported. Angel's trumpet intoxication is an important neurological emergency.
Full Text of this Article in Japanese PDF (606K)

(CLINICA NEUROL, 57: 225|229, 2017)
key words: angel's trumpet, intoxication, acute encephalopathy, mydriasis, unconsciousness

(Received: 28-Feb-17)