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Differential diagnoses include intoxication with organophosphate or carbamate insecticides, strychnine, metaldehyde, bromethalin, methylxanthines, mycotoxicosis (Penitrem A, Roquefortine), and muscarinic mushroom group ( Clitocybe and Inocybe species)

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During World War I, when cigarettes usurped cigars as the tobacco product of choice by young men, members of the royal family lent their name and image to the distribution of cigarettes to the boys in the trenches and wounded soldiers in hospitals