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Fentanyl-Induced cerebrocardial syndrome

https://doi.org/10.20340/vmi-rvz.2024.2.CLIN.6

Abstract

The clinical case is presented to demonstrate the importance of differential diagnosis of cerebral circulation disorders in patients with acute or chronic toxic effects of psychoactive substances. In the presented observation, a 50-year-old patient was taken to the N.V. Sklifosovsky Research Institute of SP with depression of the level of wakefulness to deep deafness, denies the fact of using psychoactive substances when collecting anamnesis, bilateral myosis, diffuse decrease in tone in all extremities. Computed angiotomography of the brain, transcranial dopplerography, magnetic resonance imaging of the brain, electroencephalography were performed – without obvious diagnostic findings. During a detailed examination in a neurological clinic, no data were obtained for a violation of cerebral circulation, a chemical and toxicological examination of urine and blood was performed, fentanyl was detected in biological media. Based on the literature data, however, damage to the nervous system usually occurs due to chronic intoxication and it is not always possible to detect psychoactive substances in biological environments. Due to respiratory depression, the patient was intubated and was on artificial ventilation for 72 hours until spontaneous respiration was restored. After repeated demand, the patient admitted the fact of using fentanyl allegedly to relieve pain, after which he refused further treatment. The conclusion is the need for a chemical and toxicological study of biological media in the case of a violation of consciousness of unclear genesis, however, damage to the nervous system usually occurs due to chronic intoxication and it is not always possible to detect psychoactive substances in biological media.

About the Authors

L. Kh.-B. Akhmatkhanova
N.V. Sklifosovsky Research Institute of Emergency Medicine
Russian Federation

Liana Kh.-B. Akhmatkhanova, Junior Researcher at the Scientific Department of Emergency Neurology and Restorative Treatment, neurologist at the Neurological Department for Patients with Acute Cerebral Circulatory Disorders

3, Bolshaya Sukharevskaya Square, Moscow, 129090


E. A. Kovaleva
N.V. Sklifosovsky Research Institute of Emergency Medicine
Russian Federation

Ella A. Kovaleva, Cand. Sci. (Med.), Senior Researcher at the Scientific Department of Complex Neurology and Restorative Treatment, senior lecturer of the educational department, neurologist at the Neurological Department for Patients
with Acute Cerebrovascular Disorders

3, Bolshaya Sukharevskaya Square, Moscow, 129090


I. S. Aliev
N.V. Sklifosovsky Research Institute of Emergency Medicine

Ilgar S. Aliev, Cand. Sci. (Med.), leading researcher at the Scientific Department of Complex Neurology and Rehabilitation Treatment, Head of the Intensive Care
Unit for patients with acute cerebral circulatory Disorders

3, Bolshaya Sukharevskaya Square, Moscow, 129090


Kh. V. Korigova
N.V. Sklifosovsky Research Institute of Emergency Medicine

Khedi V. Korigova, Junior Researcher at the Scientific Department of Emergency Neurology and Restorative Treatment, neurologist at the Neurological Department for Patients with Acute Cerebral Circulatory Disorders

3, Bolshaya Sukharevskaya Square, Moscow, 129090


E. V. Shevchenko
N.V. Sklifosovsky Research Institute of Emergency Medicine

Evgeniy V. Shevchenko, Cand. Sci. (Med.), Head of the Neurological Department for patients with acute cerebral hemorrhage disorders, Junior Researcher at the Scientific Department of Emergency Neurology and Rehabilitation Treatmen

3, Bolshaya Sukharevskaya Square, Moscow, 129090


A. Yu. Simonova
N.V. Sklifosovsky Research Institute of Emergency Medicine

Anastasiya Yu. Simonova, Cand. Sci. (Med.), Leading Researcher at the Department of Acute Poisoning and Somatopsychiatric Disorders

3, Bolshaya Sukharevskaya Square, Moscow, 129090


G. R. Ramazanov
N.V. Sklifosovsky Research Institute of Emergency Medicine

Ganipa R. Ramazanov, Cand. Sci. (Med.), Deputy Director – Head of the RSC, Head of the Scientific Department of Emergency Neurology and Rehabilitation Treatment

3, Bolshaya Sukharevskaya Square, Moscow, 129090


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Review

For citations:

Akhmatkhanova L.Kh., Kovaleva E.A., Aliev I.S., Korigova Kh.V., Shevchenko E.V., Simonova A.Yu., Ramazanov G.R. Fentanyl-Induced cerebrocardial syndrome. Bulletin of the Medical Institute "REAVIZ" (REHABILITATION, DOCTOR AND HEALTH). 2024;14(2):67-72. (In Russ.) https://doi.org/10.20340/vmi-rvz.2024.2.CLIN.6

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