Endocrinological and neurophysiological modifications in a case of atropinic delusional state

In this case report, we observed a delirium probably owing to toxic effects of homatropine eye drops. We reproduced this syndrome and we reversed it with physostigmine salicylate as an antidote. We observed a decrease of cortisol at 9.00 a.m. and impairment of regional cerebral blood flow with increase in the previous right side. The unusual susceptibility of this patient to the anticholinergic effect of homatropine is perhaps related to a preexisting mild cognitive defect possibly related to a cholinergic neurotransmitter deficit.