Acute polyradiculoneuropathy after amitriptyline overdose.

Acute polyradiculoneuropathy after amitriptyline overdoseDespite extensive use of amitriptyline only five cases of peripheral neuropathies have, to our knowledge, been reported.' 5No polyradiculoneuropathy has so far been related to treatment with amitriptyline. Case reportA 53 year.old depressive woman had been taking' amitriptyline 75 mg and lorazepam 2-5 mg daily in January 1984.At the beginning of February she took soluble amitriptyline 800 mg in a suicide.attempt.She became comatose, with generalised seizures, mydriasis, and urinary retention; her muscle stretch reflexes were normal, blood pressure 90/50 mm Hg, body temperature 370C, and' pulse 100 beats/min.The clinical data and an electrocardiogram were normal.She needed respiratory help and gastric evacuation.The next day she was alert, and respiratory help was stopped.She complained of weakness in her left arm that worsened during the next three days.On examination she had severe flaccid tetraplegia, no muscle stretch reflexes, complete bilateral facial and motor bulbar nerve palsy, and axial muscle palsy, resulting in her being unable to keep her head and trunk upright.Though she complained about tinglinig ensations in