Spindle coma in benzodiazepine toxicity: case report.

A forty-two year old female with known alcoholic liver disease was given intravenous lorazepam and diazepam for delirium tremens. This resulted in a comatose state with depression of some brainstem reflexes. Her initial EEG showed a pattern of spindle coma with some responsivity of the background. Clinical improvement occurred with cessation of the benzodiazepines and the EEG showed a return to normal patterns. A review of the literature showed no previous description of this pattern in benzodiazepine coma. Two reports of spindle coma are noted with alcohol and imipramine. The prognostic significance of this pattern in drug overdose is therefore not definitive by itself. Outcome is probably more dependent on the clinical condition of the patient and the reversibility of the drug toxicity.