Intoxicated patient, aggression

With mild to moderate intoxication, patients exhibit euphoria, mild incoordination, ataxia, nystagmus, and impaired judgment and reflexes. Social inhibitions are ioosened, and boisterous or aggressive behavior is common. Hypogiycemia may occur, especially in children and in persons with reduced hepatic giycogen stores. 

Rey and coworkers78 reported methyltin intoxication in six chemical workers exposed to Me2SnCl2 and MesSnCI. After a latent period of 1 -3 days, the first symptoms occurred, including headache, tinnitus, deafness, impair of memory, disorientation, aggressiveness, psychotic behavior, syncope, loss of consciousness and, in the most severe cases, respiratory depression requiring ventilatory assistance. Increased tin excretion was detected in the urine of all patients, particularly those most ill. The patient with the highest tin levels died 12 days after the initial exposure. 

V. Treatment. Patients who have self-limited mild gastrointestinal symptoms or who remain asymptomatic for 6 hours are unlikely to develop serious intoxication. On the other hand, those few with serious ingestion must be promptly and aggressively managed. 

Violent and aggressive behavior— This condition is sometimes referred to as pathological intoxication. It may be necessary for the doctor to quiet the patient with a sedative such as one of the barbiturates. 

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