Skip to main content
SpringerLink
Log in

Critical Care Seizures Related to Illicit Drugs and Toxins

  • Chapter
Seizures in Critical Care

Part of the book series: Current Clinical Neurology ((CCNEU))

  • 765 Accesses

Abstract

Seizures caused by ingestion of drugs and toxins require specific treatment aiming to terminate epileptiform activity and to eliminate the toxin. Withdrawal from regularly ingested drugs can also be accompanied by seizures requiring admission to an intensive care unit. This chapter discusses diagnostic and therapeutic particulars of seizures induced by illicit drugs of abuse, environmental toxins, and heavy metals.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 99.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Alldredge BK, Lowenstein DH, Simon RP. Seizures associated with recreational drug abuse. Neurology 1989;39:1037–1039.

    PubMed  CAS  Google Scholar 

  2. Steele MT, Westdorp EJ, Garza AG, Ma OJ, Roberts DK, Watson WA. Screening for stimulant use in adult emergency department seizure patients. J Toxicol Clin Toxicol 2000;38:609–613.

    Article  PubMed  CAS  Google Scholar 

  3. Warner-Smith M, Darke S, Day C. Morbidity associated with non-fatal heroin overdose. Addiction 2002;97:963–967.

    Article  PubMed  Google Scholar 

  4. Volavka J, Zaks A, Roubicek J, Fink M. Electrographic effects of diacetylmorphine (heroin) and naloxone in man. Neuropharmacology 1970;9:587–593.

    Article  PubMed  CAS  Google Scholar 

  5. Landow L. An apparent seizure following inadvertent intrathecal morphine. Anesthesiology 1985;62:545.

    Article  PubMed  CAS  Google Scholar 

  6. Chiarotti M, Fucci N. Comparative analysis of heroin and cocaine seizures. J Chromatogr B Biomed Sci Appl 1999;733:127–136.

    Article  PubMed  CAS  Google Scholar 

  7. Ng SK, Brust JC, Hauser WA, Susser M. Illicit drug use and the risk of new-onset seizures. Am J Epidemiol 1990;132:47–57.

    PubMed  CAS  Google Scholar 

  8. Ogunyemi AO, Locke GE, Kramer LD, Nelson L. Complex partial status epilepticus provoked by “crack” cocaine. Ann Neurol 1989;26:785–786.

    Article  PubMed  CAS  Google Scholar 

  9. Osborn DA, Jeffery HE, Cole MJ. Sedatives for opiate withdrawal in newborn infants. Cochrane Database Syst Rev 2002.

    Google Scholar 

  10. Schnorf H, Taurarii M, Cundy T. Ciguatera fish poisoning: a double-blind randomized trial of mannitol therapy. Neurology 2002;58:873–880.

    PubMed  Google Scholar 

  11. Schulze-Bonhage A, Elger CE. Induction of partial epileptic seizures by flumazenil. Epilepsia 2000;41:186–192.

    Article  PubMed  CAS  Google Scholar 

  12. Haverkos GP, DiSalvo RP, Imhoff TE. Fatal seizures after flumazenil administration in a patient with mixed overdose. Ann Pharmacother 1994;28:1347–1349.

    PubMed  CAS  Google Scholar 

  13. Sandoval MR, Palermo-Neto J. GABAergic influences on barbital withdrawal induced convulsions. Gen Pharmacol 1986;17:431–435.

    PubMed  CAS  Google Scholar 

  14. Tseng YT, Wellman SE, Ho IK. In situ hybridization evidence of differential modulation by pentobarbital of GABAA receptor alpha 1-and beta 3-subunit mRNAs. J Neurochem 1994;63:301–309.

    Article  PubMed  CAS  Google Scholar 

  15. Koff JM, Pritchard GA, Greenblatt DJ, Miller LG. The NMDA receptor competitive antagonist CPP modulates benzodiazepine tolerance and discontinuation. Pharmacology 1997;55:217–227.

    Article  PubMed  CAS  Google Scholar 

  16. Martinez-Cano H, Vela-Bueno A, de Iceta M, Pomalima R, Martinez-Gras I. Benzodiazepine withdrawal syndrome seizures. Pharmacopsychiatry 1995;28:257–262.

    PubMed  CAS  Google Scholar 

  17. Medicines Co. Systematic review of the benzodiazepines. Guidelines for data sheets on diazepam, chlordiazepoxide, medazepam, clorazepate, lorazepam, oxazepam, temazepam, triazolam, nitrazepam, and flurazepam. Br Med J 1980;280:910–912.

    Article  Google Scholar 

  18. Fraser H, Ikler A, Essig E, Isbell H. Degree of physical dependence induced by secobarbital or pentobarbital. JAMA 1958;166:126–129.

    CAS  Google Scholar 

  19. Bauer MS, Fus AF, Hanich RF, Ross RJ. Glutethimide intoxication and withdrawal. Am J Psychiatry 1988;145:530–531.

    PubMed  CAS  Google Scholar 

  20. Caplan LR, Thomas C, Banks G. Central nervous system complications of addiction to “T’s and Blues.” Neurology 1982;32:623–628.

    PubMed  CAS  Google Scholar 

  21. Landry MJ. MDMA: a review of epidemiologic data. J Psychoactive Drugs 2002;34:163–169.

    PubMed  Google Scholar 

  22. Zagnoni PG, Albano C. Psychostimulants and epilepsy. Epilepsia 2002;43(suppl 2):28–31.

    Article  PubMed  Google Scholar 

  23. Dhuna A, Pascual-Leone A, Langendorf F, Anderson DC. Epileptogenic properties of cocaine in humans. Neurotoxicology 1991;12:621–626.

    PubMed  CAS  Google Scholar 

  24. Burgess C, O’Donohoe A, Gill M. Agony and ecstasy: a review of MDMA effects and toxicity. Eur Psychiatry 2000;15:287–294.

    Article  PubMed  CAS  Google Scholar 

  25. Gowing LR, Henry-Edwards SM, Irvine RJ, Ali RL. The health effects of ecstasy: a literature review. Drug Alcohol Rev 2002;21:53–63.

    Article  PubMed  Google Scholar 

  26. Auer J, Berent R, Weber T, Lassnig E, Eber B. Subarachnoid haemorrhage with “ecstasy” abuse in a young adult. Neurol Sci 2002;23:199–201.

    Article  PubMed  CAS  Google Scholar 

  27. Klausner HA, Lewandowski C. Infrequent causes of stroke. Emerg Med Clin North Am 2002;20:657–670.

    Article  PubMed  Google Scholar 

  28. Hanson GR, Jensen M, Johnson M, White HS. Distinct features of seizures induced by cocaine and amphetamine analogs. Eur J Pharmacol 1999;377:167–173.

    Article  PubMed  CAS  Google Scholar 

  29. Schwartz RH, Estroff T, Hoffmann NG. Seizures and syncope in adolescent cocaine abusers. Am J Med 1988;85:462.

    Article  PubMed  CAS  Google Scholar 

  30. Holmes SB, Banerjee AK, Alexander WD. Hyponatraemia and seizures after ecstasy use. Postgrad Med J 1999;75:32–33.

    PubMed  CAS  Google Scholar 

  31. Sue YM, Lee YL, Huang JJ. Acute hyponatremia, seizure, and rhabdomyolysis after ecstasy use. J Toxicol Clin Toxicol 2002;40:931–932.

    Article  PubMed  Google Scholar 

  32. Szlatenyi CS, Wang RY. Encephalopathy and cranial nerve palsies caused by intentional trichloroethylene inhalation. Am J Emerg Med 1996;14:464–466.

    Article  PubMed  CAS  Google Scholar 

  33. Aydin K, Sencer S, Demir T, Ogel K, Tunaci A, Minareci O. Cranial MR findings in chronic toluene abuse by inhalation. AJNR Am J Neuroradiol 2002;23:1173–1179.

    PubMed  Google Scholar 

  34. Meredith TJ, Ruprah M, Liddle A, Flanagan RJ. Diagnosis and treatment of acute poisoning with volatile substances. Hum Toxicol 1989;8:277–286.

    PubMed  CAS  Google Scholar 

  35. Wells JC. Abuse of trichloroethylene by oral self-administration. Anaesthesia 1982;37:440–441.

    Article  PubMed  CAS  Google Scholar 

  36. Littorin ME, Fehling C, Attewell RG, Skerfving S. Focal epilepsy and exposure to organic solvents: a case-referent study. J Occup Med 1988;30:805–808.

    Article  PubMed  CAS  Google Scholar 

  37. Silva-Filho AR, Pires ML, Shiotsuki N. Anticonvulsant and convulsant effects of organic solvents. Pharmacol Biochem Behav 1992;41:79–82.

    Article  PubMed  CAS  Google Scholar 

  38. Jacobsen M, Baelum J, Bonde JP. Temporal epileptic seizures and occupational exposure to solvents. Occup Environ Med 1994;51:429–430.

    PubMed  CAS  Google Scholar 

  39. Wilson RI, Nicoll RA. Endocannabinoid signaling in the brain. Science 2002;296:678–682.

    Article  PubMed  CAS  Google Scholar 

  40. Mechoulam R, Parker LA, Gallily R. Cannabidiol: an overview of some pharmacological aspects. J Clin Pharmacol 2002;42:11S–19S.

    PubMed  CAS  Google Scholar 

  41. Sofia RD, Solomon TA, Barry H, 3rd. Anticonvulsant activity of delta 9-tetrahydrocannabinol compared with three other drugs. Eur J Pharmacol 1976;35:7–16.

    Article  PubMed  CAS  Google Scholar 

  42. Karler R, Turkanis SA. The cannabinoids as potential antiepileptics. J Clin Pharmacol 1981;21:437S–448S.

    PubMed  CAS  Google Scholar 

  43. Turkanis SA, Karler R. Central excitatory properties of delta 9-tetrahydrocannabinol and its metabolites in iron-induced epileptic rats. Neuropharmacology 1982;21:7–13.

    Article  PubMed  CAS  Google Scholar 

  44. Fisher DD, Ungerleider JT. Grand mal seizures following ingestion of LSD. Calif Med 1967;106:210–211.

    PubMed  CAS  Google Scholar 

  45. Leander JD, Rathbun RC, Zimmerman DM. Anticonvulsant effects of phencyclidine-like drugs: relation to N-methyl-D-aspartic acid antagonism. Brain Res 1988;454:368–372.

    Article  PubMed  CAS  Google Scholar 

  46. Baldridge EB, Bessen HA. Phencyclidine. Emerg Med Clin North Am 1990;8:541–550.

    PubMed  CAS  Google Scholar 

  47. Kessler GF, Jr, Demers LM, Berlin C, Brennan RW. Letter: phencyclidine and fatal status epilepticus. N Engl J Med 1974;291:979.

    PubMed  Google Scholar 

  48. Stewart GR, Zorumski CF, Price MT, Olney JW. Domoic acid: a dementia-inducing excitotoxic food poison with kainic acid receptor specificity. Exp Neurol 1990;110:127–138.

    Article  PubMed  CAS  Google Scholar 

  49. Cervos-Navarro J, Diemer NH. Selective vulnerability in brain hypoxia. Crit Rev Neurobiol 1991;6:149–182.

    PubMed  CAS  Google Scholar 

  50. Perl TM, Bedard L, Kosatsky T, Hockin JC, Todd EC, Remis RS. An outbreak of toxic encephalopathy caused by eating mussels contaminated with domoic acid. N Engl J Med 1990;322:1775–1780.

    PubMed  CAS  Google Scholar 

  51. Teitelbaum JS, Zatorre RJ, Carpenter S, Gendron D, Evans AC, Gjedde A, Cashman NR. Neurologic sequelae of domoic acid intoxication due to the ingestion of contaminated mussels. N Engl J Med 1990;322:1781–1787.

    PubMed  CAS  Google Scholar 

  52. Cendes F, Andermann F, Carpenter S, Zatorre RJ, Cashman NR. Temporal lobe epilepsy caused by domoic acid intoxication: evidence for glutamate receptor-mediated excitotoxicity in humans. Ann Neurol 1995;37:123–126.

    Article  PubMed  CAS  Google Scholar 

  53. Pearn J. Neurology of ciguatera. J Neurol Neurosurg Psychiatry 2001;70:4–8.

    Article  PubMed  CAS  Google Scholar 

  54. Ting JY, Brown AF. Ciguatera poisoning: a global issue with common management problems. Eur J Emerg Med 2001;8:295–300.

    Article  PubMed  CAS  Google Scholar 

  55. Hashmi MA, Sorokin JJ, Levine SM. Ciguatera fish poisoning. N J Med 1989;86:469–471.

    PubMed  CAS  Google Scholar 

  56. Lange WR. Ciguatera toxicity. Am Fam Physician 1987;35:177–182.

    PubMed  CAS  Google Scholar 

  57. Bagnis R, Kuberski T, Laugier S. Clinical observations on 3009 cases of ciguatera (fish poisoning) in the South Pacific. Am J Trop Med Hyg 1979;28:1067–1073.

    PubMed  CAS  Google Scholar 

  58. Alcala AC, Alcala LC, Garth JS, Yasumura D, Yasumoto T. Human fatality due to ingestion of the crab Demania reynaudii that contained a palytoxin-like toxin. Toxicon 1988;26:105–107.

    Article  PubMed  CAS  Google Scholar 

  59. Matta J, Navas J, Milad M, Manger R, Hupka A, Frazer T. A pilot study for the detection of acute ciguatera intoxication in human blood. J Toxicol Clin Toxicol 2002;40:49–57.

    PubMed  CAS  Google Scholar 

  60. Palafox NA, Jain LG, Pinano AZ, Gulick TM, Williams RK, Schatz IJ. Successful treatment of ciguatera fish poisoning with intravenous mannitol. JAMA 1988;259:2740–2742.

    Article  PubMed  CAS  Google Scholar 

  61. Chilton WS, Ott J. Toxic metabolites of Amanita pantherina, A. cothurnata, A. muscaria and other Amanita species. Lloydia 1976;39:150–157.

    PubMed  CAS  Google Scholar 

  62. McPartland JM, Vilgalys RJ, Cubeta MA. Mushroom poisoning. Am Fam Physician 1997;55:1797–1800.

    PubMed  CAS  Google Scholar 

  63. Albrecht J, Jones EA. Hepatic encephalopathy: molecular mechanisms underlying the clinical syndrome. J Neurol Sci 1999;170:138–146.

    Article  PubMed  CAS  Google Scholar 

  64. Sabeel AI, Kurkus J, Lindholm T. Intensive hemodialysis and hemoperfusion treatment of Amanita mushroom poisoning. Mycopathologia 1995;131:107–114.

    Article  PubMed  CAS  Google Scholar 

  65. Beer JH. The wrong mushroom. Diagnosis and therapy of mushroom poisoning, especially of Amanita phalloides poisoning (in German). Schweiz Med Wochenschr 1993;123:892–905.

    PubMed  CAS  Google Scholar 

  66. Montanini S, Sinardi D, Pratico C, Sinardi AU, Trimarchi G. Use of acetylcysteine as the life-saving antidote in Amanita phalloides (death cap) poisoning. Case report on 11 patients. Arzneimittelforschung 1999;49:1044–1047.

    PubMed  CAS  Google Scholar 

  67. Kohn R, Mot’ovska Z. Mushroom poisoning—classification, symptoms and therapy (in Polish). Vnitr Lek 1997;43:230–233.

    PubMed  CAS  Google Scholar 

  68. Tupalska-Wilczynska K, Ignatowicz R, Poziemski A, Wojcik H, Wilczynski G. Amanita pantherina and Amanita muscaria poisonings—pathogenesis, symptoms and treatment in Polish). Pol Merkuriusz Lek 1997;3:30–32.

    CAS  Google Scholar 

  69. Benjamin DR. Mushroom poisoning in infants and children: the Amanita pantherina/muscaria group. J Toxicol Clin Toxicol 1992;30:13–22.

    PubMed  CAS  Google Scholar 

  70. Elonen E, Tarssanen L, Harkonen M. Poisoning with brown fly agaric, Amanita regalis. Acta Med Scand 1979;205:121–123.

    PubMed  CAS  Google Scholar 

  71. Anon. From the Centers for Disease Control and Prevention. Water hemlock poisoning—Maine, 1992. JAMA 1994;271:1475.

    Article  Google Scholar 

  72. Knutsen OH, Paszkowski P. New aspects in the treatment of water hemlock poisoning. J Toxicol Clin Toxicol 1984;22:157–166.

    PubMed  CAS  Google Scholar 

  73. Kunisaki TA, Augenstein WL. Drug-and toxin-induced seizures. Emerg Med Clin North Am 1994;12:1027–1056.

    PubMed  CAS  Google Scholar 

  74. Ertekin V, Alp H, Selimoglu MA, Karacan M. Amitraz poisoning in children: retrospective analysis of 21 cases. J Int Med Res 2002;30:203–205.

    PubMed  CAS  Google Scholar 

  75. Yilmaz HL, Yildizdas DR. Amitraz poisoning, an emerging problem: epidemiology, clinical features, management, and preventive strategies. Arch Dis Child 2003;88:130–134.

    Article  PubMed  CAS  Google Scholar 

  76. Heckerling PS, Leikin JB, Maturen A, Terzian CG, Segarra DP. Screening hospital admissions from the emergency department for occult carbon monoxide poisoning. Am J Emerg Med 1990;8:301–304.

    Article  PubMed  CAS  Google Scholar 

  77. Herman LY. Carbon monoxide poisoning presenting as an isolated seizure. J Emerg Med 1998;16:429–432.

    Article  PubMed  CAS  Google Scholar 

  78. Mori T, Nagai K. Carbon-monoxide poisoning presenting as an afebrile seizure. Pediatr Neurol 2000;22:330–331.

    Article  PubMed  CAS  Google Scholar 

  79. Durnin C. Carbon monoxide poisoning presenting with focal epileptiform seizures. Lancet 1987;1:1319.

    Article  PubMed  CAS  Google Scholar 

  80. Kales SN. Carbon monoxide intoxication. Am Fam Physician 1993;48:1100–1104.

    PubMed  CAS  Google Scholar 

  81. Neufeld MY, Swanson JW, Klass DW. Localized EEG abnormalities in acute carbon monoxide poisoning. Arch Neurol 1981;38:524–527.

    PubMed  CAS  Google Scholar 

  82. Mathieu D, Nolf M, Durocher A, et al. Acute carbon monoxide poisoning. Risk of late sequelae and treatment by hyperbaric oxygen. J Toxicol Clin Toxicol 1985;23:315–324.

    PubMed  CAS  Google Scholar 

  83. Hawkins M, Harrison J, Charters P. Severe carbon monoxide poisoning: outcome after hyperbaric oxygen therapy. Br J Anaesth 2000;84:584–586.

    PubMed  CAS  Google Scholar 

  84. Weaver LK, Hopkins RO, Chan KJ, et al. Hyperbaric oxygen for acute carbon monoxide poisoning. N Engl J Med 2002;347:1057–1067.

    Article  PubMed  CAS  Google Scholar 

  85. Hampson NB, Simonson SG, Kramer CC, Piantadosi CA. Central nervous system oxygen toxicity during hyperbaric treatment of patients with carbon monoxide poisoning. Undersea Hyperbaric Med 1996;23:215–219.

    CAS  Google Scholar 

  86. Roscoe RJ, Ball W, Curran JJ, et al. Adult blood lead epidemiology and surveillance—United States, 1998–2001. MMWR Surveillance Summ 2002;51:1–10.

    Google Scholar 

  87. Shannon M. Severe lead poisoning in pregnancy. Ambul Pediatr 2003;3:37–39.

    Article  PubMed  Google Scholar 

  88. Wedeen RP, Mallik DK, Batuman V, Bogden JD. Geophagic lead nephropathy: case report. Environ Res 1978;17:409–415.

    Article  PubMed  CAS  Google Scholar 

  89. Kumar A, Dey PK, Singla PN, Ambasht RS, Upadhyay SK. Blood lead levels in children with neurological disorders. J Trop Pediatr 1998;44:320–322.

    Article  PubMed  CAS  Google Scholar 

  90. Yu EC, Yeung CY. Lead encephalopathy due to herbal medicine. Chin Med J (Engl) 1987;100:915–917.

    CAS  Google Scholar 

  91. Healy MA, Aslam M, Harrison PG, Fernando NP. Lead-induced convulsions in young infants—a case history and the role of GABA and sodium valproate in the pathogenesis and treatment. J Clin Hosp Pharm 1984;9:199–207.

    PubMed  CAS  Google Scholar 

  92. Cheong JH, Seo DO, Ryu JR, et al. Lead induced thiamine deficiency in the brain decreased the threshold of electroshock seizure in rat. Toxicology 1999;133:105–113.

    Article  PubMed  CAS  Google Scholar 

  93. Gordon JN, Taylor A, Bennett PN. Lead poisoning: case studies. Br J Clin Pharmacol 2002;53:451–458.

    Article  PubMed  CAS  Google Scholar 

  94. Pelclova D, Lukas E, Urban P, et al. Mercury intoxication from skin ointment containing mercuric ammonium chloride. Int Arch Occup Environ Health 2002;75suppl:S54–S59.

    PubMed  CAS  Google Scholar 

  95. Faria MMA. Chronic occupational metallic mercurialism. Rev Saude Publica 2003;37:116–127.

    Google Scholar 

  96. Evans EC. The FDA recommendations on fish intake during pregnancy. J Obstet Gynecol Neonatal Nurs 2002;31:715–720.

    PubMed  Google Scholar 

  97. Juarez BI, Martinez ML, Montante M, Dufour L, Garcia E, Jimenez-Capdeville ME. Methylmercury increases glutamate extracellular levels in frontal cortex of awake rats. Neurotoxicol Teratol 2002;24:767–771.

    Article  PubMed  CAS  Google Scholar 

  98. Jaffe KM, Shurtleff DB, Robertson WO. Survival after acute mercury vapor poisoning. Am J Dis Child 1983;137:749–751.

    PubMed  CAS  Google Scholar 

  99. Winker R, Schaffer AW, Konnaris C, et al. Health consequences of an intravenous injection of metallic mercury. Int Arch Occup Environ Health 2002;75:581–586.

    Article  PubMed  CAS  Google Scholar 

  100. Brenner RP, Snyder RD. Late EEG findings and clinical status after organic mercury poisoning. Arch Neurol 1980;37:282–284.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neurology, University of Tübingen, Tübingen, Germany

    Andreas R. Luft MD

Authors
  1. Andreas R. Luft MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Neurointensive Care Unit, and Department of Neurology, Medical College of Wisconsin, Milwaukee, WI

    Panayiotis N. Varelas MD, PhD

Rights and permissions

Reprints and permissions

Copyright information

© 2005 Humana Press Inc., Totowa, NJ

About this chapter

Cite this chapter

Luft, A.R. (2005). Critical Care Seizures Related to Illicit Drugs and Toxins. In: Varelas, P.N. (eds) Seizures in Critical Care. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-59259-841-0_13

Download citation

  • DOI: https://doi.org/10.1007/978-1-59259-841-0_13

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-58829-342-8

  • Online ISBN: 978-1-59259-841-0

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation