Prolonged obstructive jaundice and haemangiomatosis

children with malignant disease receiving phenothiazines for nausea, cerebral metastases or irradiation effects may be considered (Cottom and Newman, 1966). The acute toxic reactions to phenothiazines are self-limiting, the symptoms subsiding in 24 to 48 hours. They can, however, be rapidly and specifically relieved by the anticholinergic/antihistamine group of drugs commonly used for the treatment of Parkinsonism. Such a drug is benztropine methanesulphonate which has been in use since 1952 and is especially effective in relieving 'frozen states' (Doshay, 1956). It has very few side effects, these being mainly due to its mild anticholinergic actions. Given intramuscularly it acts in about 10 minutes and maximally at half an hour, but intravenously it relieves a highly alarming and stressful state almost instantly. The phenothiazine group of drugs are frequently prescribed to children for their anti-emetic action and the serious nature of the toxic reactions is not widely appreciated. They are commonly seen with overdoses, but may also occur with therapeutic doses. Intoxication is particularly liable to occur in children and is predisposed to by states of fever or dehydration (Duffy, 1971). It is suggested that the phenothiazines should be used with great caution in childhood and avoided if possible. In any case of dyskinesia it is most important to take a full drug history including those prescribed for other members of the household.