Undiagnosed central anticholinergic syndrome may lead to dangerous complications

This report describes two cases of central anticholinergic syndrome, the fi rst after general anaesthesia and the other during a prolonged stay in the intensive care unit. The symptoms in both patients resolved soon after phys ostigmine administration. There was a delay in the diagnosis of central ant icholinergic syndrome, which resulted in acute lung injury and unanticipate d intensive care unit admission. It is suggested that in cases of abnormal mental recovery after anaesthesia or sedation, the diagnosis of central ant icholinergic syndrome should be considered.