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Abstract Details

The Role of EEG in the Diagnosis of Serotonin Syndrome: A Case Study

A 44-year-old male with a complex psychiatric history presented to the emergency department after collapsing and displaying abnormal movements of his arms with slurred speech. This was preceded by several weeks of feeling unwell. On admission his medications included venlafaxine MR 300mg, quetiapine 150mg BD, clomethiozole 384mg OD, zomorph 20mg BD, pregabalin 300mg BD and diazepam 2mg TDS. In the days before his admission he presented to his GP with myoclonic jerks and was prescribed procyclidine. This was stopped following the initial dose as it was thought to cause him diarrhoea. While in ED he had a self terminating generalised tonic-clonic seizure of 5 minutes duration and afterwards was combative and agitated at times. On examination he displayed abnormal neurology including oro-facial movements and odd posturing and had a systemic inflammatory response syndrome (SIRS). An ECG, chest x-ray and CT head showed no abnormalities, an MRI head ruled out limbic encephalitis. He was transferred to ITU where he continued to have abnormal neurology, SIRS and ongoing loose stools and an EEG was requested to aid diagnosis. This showed activity suggestive of Serotonin Syndrome (SS) and both the quetiapine and venlafaxine were withheld. Over the subsequent two days his abnormal neurology and SIRS resolved and by the fifth day he was more alert and talking. Two months following his admission he had a repeat EEG as an outpatient which was normal.
Summer Scientific Meeting and AGM
TitleForenamesSurnameInstitutionLead AuthorPresenter
 HannahCockerillQueen Alexandra Hospital, Portsmouth
DrTheebaKrishnamoorthyPortsmouth Hospitals NHS Trust
DrJohnKnightonPortsmouth Hospitals NHS Trust
DrW LouisMertonQueen Alexandra Hospital
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