Since its debut in the 1960s, the broad use and availability of benzodiazepines has mirrored the
increased incidence of overdose cases. Due to its non-specic presentation, there is often a delay in
diagnosis. We report a case of Benzodiazepine toxicity in a 70-year-old man who presented to us in a comatose state. He was
evaluated at another hospital initially and was intubated in view of his low Glasgow Coma scale. A CT brain plain study was
done suspecting a basilar artery thrombus and he was referred to us for Neuro-Interventional procedures. As radiological,
laboratory and electrophysiological investigations were unremarkable a provisional diagnosis of drug intoxication was made
after patient medication review and a trial of Flumazenil was given, after which the patient had improved dramatically.
Flumazenil is not routinely used due to fears of withdrawal seizures and its high cost. It also has no effect on reversing sedation
caused by barbiturates, ethanol, or opioids. The antidote has a favorable risk-benet ratio when dosed appropriately and can
be a helpful diagnostic tool after ruling out the more common causes of acute sensorium loss as demonstrated by this case
report.
What determines the duration of patient medication compliance in patients with chronic disease: are we looking in the wrong place?