• Datura stramonium intoxication
• coma
• focal neurological deficits

Intoxication with Datura stramonium, which contains a variety of tropine alkaloids, produces atropine-like effects. The seeds of D stramonium (semen stramonii) in particular contain hyoscyamine, scopolamine, and atropine. Symptoms include agitation, disorientation, hallucination, flushed skin, dilatation of pupils, urine retention, seizures, and respiratory depression.¹ D stramonium is voluntarily used for its hallucinogenic properties.² Its anticholinergic compounds are likely to produce delirium and stupor but rarely cause deep coma.³

A common diagnostic error is to mistake coma resulting from brainstem infarction, supratentorial mass lesions, metabolic disorders, or hypoxia for coma resulting from poisoning. The initial distinction of these conditions may be difficult.⁴ We report an unusual case of D stramonium intoxication in a patient who initially presented with deep coma, focal neurological signs, and decorticate posture.

A 30 year old male patient was admitted to an emergency unit for acute loss of consciousness. The accompanying person reported that the patient had had a few beers and then suddenly fell on his back. He was unconscious and awoke for a few seconds but shortly afterward lost consciousness again and remained in a stiff position and unconscious until admission.

The first neurological examination was performed one and a half hours …