Iranian Journal of Child Neurology

Abstract

How to Cite This Article: Bazmamoun H, Fayyazi A, Khajeh A, Sabzehei MK, Khezrian F. A Study of Methadone-Poisoned Children Referred to Hamadan’s Be’sat Hospital Iran. Iran J Child Neurol. 2014 Spring 8(2):34-37.

Objective
Increasing use of methadone in withdrawal programs has increased methadone poisoning in children. This research aimed to study the causes of incidence of poisoning in children and its side-effects.

Materials & Methods
In this research, The hospital records of all methadone-poisoned children referred to Hamadan’s Be’sat Hospital from June 2007 to March 2013, were studied. Children with a definite history of methadone use or proven existence
of methadone in their urine, were studied.

Results
During 5 years, 62 children with the mean age of 53.24±29.50 months were hospitalized due to methadone use. There was a significant relationship between
delayed referral to hospital and increased bradypnea. According to their history, 25.8% and 58.1% of the children had been poisoned by methadone tablet and syrup, respectively. The most common initial complaint expressed by parents, was decreased consciousness (85.5%). During the initial examination, decreased consciousness, meiosis, and respiratory depression were observed in 91.9%,
82.3%, and 69.4% of the cases, respectively. Nine patients required mechanical ventilation. There was a significant relationship between the need for mechanical ventilation and seizure with initial symptom of emesis. There were two cases of death (3.2%), both of which were secondary to prolonged hypoxia and brain death. There was a significant relationship between poor patient prognosis (death) and presence of cyanosis in early symptoms, seizure, hypotension, duration of decreased consciousness, and duration of mechanical ventilation.

Conclusion
This research indicated that the occurrence of seizure, hypotension, and cyanosis in the early stages of poisoning is associated with an increased risk of sideeffects and death and are serious warning signs. Early diagnosis and intervention can improve outcomes of methadone-poisoned children.

References

1. Nazari H. Clinical approach to methadone intoxication. J Addict 2007;2:18-20.

2. Fayyazi A, Bagheri M, Khajeh A, Ahmadi S. Acute hydrocephaly following methadone intoxication in a child. Iran J Child Neurol. 2012;6(1):35-8.

3. Binchy JM, Molyneux EM, Manning J. Accidental ingestion of methadone by children in Merseyside. BMJ.1994; 308(6940):1335-6.

4. Li L, Levine B, Smialek JE. Fatal methadone poisoning in children: Maryland 1992–1996. Subst Use Misuse 2000;35(9):1141-8.

5. Riascos R, Kumfa P, Rojas R, Cuellar H, Descartes F. Fatal methadone intoxication in a child. Emerg Radiol 2008;15(1):67-70.

6. Milroy CM, Forrest AR. Methadone deaths: a toxicological analysis. J Clin Pathol 2000;53(4):277-81.

7. Farnaghi F, Jafari N, Mehregan FF. Methadone Poisoning among Children Referred to Loghman-Hakim Hospital in 2009. Pajoohandeh Journal 2012;16(6):299-303.

8. Zamani N, Sanaei-zadeh H, Mostafazadeh B. hallmarks of opium poisoning in infants and toddlers. Trop Doct 2010;40 (4):220-2.

9. Malloy S, Soh C, Williams TL Reversible delayed post hypoxic leukoencephalopathy. Am J Neuroradiol 2006; 27(8):1763–5.

10. Geibprasert S, Gallucci M and KringsT. Addictive Illegal Drugs: Structural Neuroimaging. Am J Neuroradiol 2010;31(5):803-8.