A sound sleep

Abstract

Benzodiazepine is a commonly encountered agent of poisoning, which is readily diagnosed by a pertinent history of drug ingestion and the clinical scenario. In the absence of a proper drug history, the diagnosis becomes challenging. Proper clinical assessment, urine assays and imaging play a very important role in reaching the diagnosis. We present a case of acute benzodiazepine poisoning without a history of drug intake. The key pointers toward diagnosis were an unarousable state with obstructive apnea. Magnetic resonance imaging (MRI) of the brain revealed peculiar symmetrical isolated globus pallidus T2 hyperintensity. We believe this to be the first report of isolated bilateral basal ganglia T2-weighted hyperintensity in MRI in the setting of acute benzodiazepine poisoning from India.