In the Netherlands a young man named Jan was admitted to the

In the Netherlands a young man named Jan was admitted to the emergency room. He and his friends had been to a rave. His friends say he started twitching and having muscle spasms which progressed until he was \"stiff as a board. On examination, staff found a marked increase in muscle tone and hyperreflexia involving facial and limb muscles. In his pocket, he had unmarked dark yellow tablets with dark flecks. Analysis of the tablets showed them to contain a mixture of ecstasy and strychnine. Ecstasy would not cause this clinical picture, but strychnine, which blocks glycine receptors, could. Explain how.

Solution

Ecstasy and strychnine was taken together in the rave. Signs like twitching muscle, spasms, stiff ness in muscle were shown. Strychnine which was taken by Jan in the rave blocked glycine receptors (acts as an antagonist of glycine and acetylcholine receptors) in his spinal cord which caused spasms and stiff ness and muscular convulsions. Glycine act as an inhibitory neurotransmitter. The spastic concentration reached to higher level from where it became permanently stiff and was not able to relax so he became as stiff as a board. Muscle spasms in Mr. Jan was raised due to combined dose of Ecstasy which specifically cause jaw-clenching by acting on his motor neurons in the spinal cord and would have caused muscle breakdown and renal failure due to salt and fluid depletion.