Methylphenidate Poisoning: Carpopedal Spasm in a Child

Abstract

Stimulant drugs including methylphenidate (MPH) are the first-line treatment for school-aged children and adolescents with attention-deficit hyperactivity disorder (ADHD). Since its availability, MPH overdoses have been seen more commonly similar to overdoses with other amphetamine-like drugs. Although the clinical manifestations include symphathomimetic findings like irritability, agitation, palpitation, hyperreflexia, seizures, hypertension, hyperventilation and hyperthermia, it may also cause stroke, tics, toxic psychosis, Tourettes syndrome and neuromuscular findings such as dyskinesia and paresthesia. Carpopedal spasm is a rare feature of MPH overdose. It may be triggered by alkalosis-induced hypocalcamia or cerebral vasoconstriction associated with hypocapnia. In this case report, we presented a 10-year-old girl who had carpopedal spasm after 3 - 4 h from taking the MPH with high dosage. Paper bag ventilation as the treatment had a significant improving effect on carpopedal spasm.




J Med Cases. 2014;5(1):31-33
doi: https://doi.org/10.4021/jmc1616w