with the use of sympathomimetics such as ephedrine in Case reportnasal decongestants, or herbal stimulants and betaagonists in asthma. We therefore propose that autonomic A 46-year-old paraplegic woman had suCered a spinal cord injury (level of injury T6-T7) 19 years earlier and hyper-reflexia and treatment with muscarinic receptor antagonists may result in visual hallucinations, and we was using CISC; however, this became unsatisfactory after an abdominal hysterectomy. Tolterodine (2 mg suggest caution at the onset of tolterodine treatment in patients with a high-level spinal cord injury. twice daily) was given to increase the functional bladder capacity. Four days later she complained of seeing snakes; visual hallucinations persisted for the duration of the treatment (5 days) and subsided within 3 days of disconReferences tinuing tolterodine.

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