A 25-year-old white man presented to the emergency department with altered mental
status and stupor. He and his girlfriend were dropped off at the triage entrance by
a friend who was concerned after he started behaving erratically, became confused,
and possibly had “walking seizures.” He was limp with a decreased level of consciousness
and was quickly rushed back to the resuscitation room. The friend stated that the
patient had recreationally ingested phenibut pills, which were obtained over the Internet.
At this time, no further medical history was available. Physical examination revealed
a blood pressure of 121/61, pulse of 60, rectal temperature of 35.3°C, and a respiratory
rate of 10 breaths per minute. In general, he was somnolent but arousable with sternal
rub. Pupils were dilated to 8 mm bilaterally and were sluggishly reactive. Respirations
were shallow without wheezing. Cardiac and abdominal examinations were benign. The
Glasgow Coma Scale was 10 (E2M3V5).
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Article Info
Publication History
Published online: September 01, 2016
Accepted:
August 29,
2016
Received:
August 19,
2016
Identification
Copyright
© 2016 Elsevier Inc. All rights reserved.
