Abstract

Contamination of traditional Chinese medicine (TCM) by tropane alkaloids can cause delirium. We report the first case of delirium in a 79-year-old Chinese woman due to contaminated Strobilanthes forrestii Diels. She presented visual hallucination, disorientation, slurred speech, clumsiness in four limbs and generalized weakness 1 hour after taking herbal tea. Tropane alkaloids were detected in the urine by gas chromatography mass spectrometry. The effects of tropane alkaloid subsided 12 hours later. Strobilanthes forrestii Diels was found to be wrongly prescribed and contaminated with tropane alkaloid at the herb processing factory. TCM is a potential cause of delirium.

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