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Abstract
Background. The use of competitive inhibitors of acetylcholine other than atropine, for patients with organophosphate poisoning, is controversial. Because scopolamine ability to cross the blood-brain barrier is better than that of atropine, it has been suggested that it should be used in patients with organophosphate poisoning who have central nervous system manifestations. Case Description. A 17-year-old girl was admitted to the pediatric ward after ingesting chlorpyrifos as a suicidal attempt. She reported vomiting three times. She had no other symptoms for 12 hours and then over the course of 36 hours gradually developed extra-pyramidal signs and became comatose. She was treated with intravenous scopolamine. Within 3 minutes the patient started to respond to verbal commands and answered simple questions, rigidity subsided, and she was able to sit in bed. She was discharged after 4 days with no neurological sequelae. Conclusions. We suggest, that in patients with organophosphate poisoning who have mainly central nervous system toxicity, scopolamine administration might be considered.