Accidental haloperidol poisoning in children
The younger sibling, a 4 year-old male child was also brought with complaints of excessive sleepiness on the later part of the same day. On examination, he was drowsy but arousable obeying verbal commands but not vocalizing. Though his vitals were stable, he had anticholinergic symptoms such as diaphoresis, hyperthermia and urinary retention. On detailed CNS exam, generalized dystonia with intention tremors, perioral tremors, tongue fasciculations, nystagmus and hypereflexia was present. On further enquiry, it was revealed that he too while playing along with his sister, had consumed an unknown number of the same tablets. He was admitted, and after a stomach wash, started on trihexyphenidyl and symptomatic treatment. After 24 h, his involuntary movements persisted so he was started on promethazine IV 0.1 mg/kg/dose single-dose after which, his symptoms subsided over a period of 72 h after admission and he gradually improved and regained consciousness. On follow-up after 1 week, both siblings were asymptomatic and doing well. Psychiatric evaluation and counseling of the children and parents was done.