benztropine and Fever

The diagnosis of autoerotic death is most often made when there has been accidental asphyxia from ropes or ligatures used by the deceased as a part of his or her autoerotic ritual. Three cases of probable autoerotic death are reported in which the mechanisms of death involved hyperthermia, sepsis, and hemorrhage, respectively. Case 1: A 46-year-old man was found dead in bushland clothed in a dress, female undergarments, and seven pairs of stockings/pantyhose. The underwear had been cut to enable exposure of the genitals. The recorded daily maximum temperature was 39 degrees C, and the deceased had been taking the drug benztropine. Death was attributed to hyperthermia due to a combination of excessive clothing, high ambient temperature, and prescription drug side effect. Case 2: A 40-year-old man was found dead in his boarding house. At autopsy, a pencil was found within his abdominal cavity with perforation of the bladder and peritonitis. Death was attributed to peritonitis/sepsis following intraurethral introduction of a pencil. Case 3: A 56-year-old man was found dead lying on his bed following massive rectal hemorrhage. A blood stained shoe horn was found nearby. Death was attributed to hemorrhage following laceration of the anal canal with a shoe horn. The diagnosis of autoerotic death may be difficult when typical features are absent, however, any unusual injury associated with genitourinary manipulation must raise this possibility.

Topics: Adult; Antiparkinson Agents; Autopsy; Benztropine; Cause of Death; Clothing; Fever; Foreign Bodies; Gastrointestinal Hemorrhage; Hot Temperature; Humans; Male; Middle Aged; Peritonitis; Rectum; Sexual Behavior; Urinary Bladder

Neuroleptic Malignant Syndrome (NMS) is a life-threatening adverse reaction arising from the use of neuroleptic medications. While dopaminergic agonists, dantrolrene and supportive care are traditionally utilized in the stabilization and management of NMS, anticholinergic medication may also prove effective therapy. Treatment with anticholinergic medication has been suggested in cases of NMS associated with mild hyperthermia. We describe a case of 17-y-old female, who was brought to the emergency department for a possible "acute dystonic reaction". The patient received 50 mg diphenhydramine i.v., which resulted in improvement in mental status. The patient was readmitted to the emergency department 1 d following discharge with symptoms similar, but now considering the diagnosis of NMS. Diphenhydramine 50 mg i.v. was again administered and resulted in significant improvement.

Topics: Adolescent; Benztropine; Cholinergic Antagonists; Diphenhydramine; Female; Fever; Fluphenazine; Humans; Lithium Chloride; Neuroleptic Malignant Syndrome

Topics: Benztropine; Droperidol; Electroconvulsive Therapy; Fever; Humans; Restraint, Physical; Tropanes

Topics: Adult; Basal Ganglia Diseases; Benztropine; Catatonia; Coma; Creatine Kinase; Female; Fever; Fluphenazine; Humans; Movement Disorders; Muscle Rigidity; Phenothiazines; Schizophrenia; Syndrome

Topics: Adult; Antiparkinson Agents; Benztropine; Chlorpromazine; Fever; Haloperidol; Humans; Male; Mutism; Tropanes