MULTIPLE COCAINE-INDUCED SEIZURES AND CORRESPONDING COCAINE AND METABOLITE CONCENTRATIONS

The etiology of seizures associated with cocaine use is unclear. Becau se cocaine seizures are relatively uncommon, they should be diagnosed by exclusion and a neurological workup to rule out central nervous sys tem (CNS) catastrophe should be made. This report describes the clinic al findings, treatment, and blood cocaine and metabolite concentration s in a patient who, on two separate occasions, had seizures associated with crack cocaine ingestion. Approximately 1 hour after the ingestio n incidents, the patient had multiple, generalized seizures that abate d spontaneously, His workup for CNS bleeding, infection, and trauma wa s negative. Cocaine concentrations on the first incident peaked at 2.4 8 mg/L and on the second incident peaked at 3.9 mg/L, Other clinical f indings included tachycardia, hypertension, diaphoresis, and disorient ation, Brood cocaine and metabolite analysis revealed extremely high c oncentrations, Other than the incident of seizures and transient cardi ovascular aberrations, these high concentrations were tolerated by the patient without further sequelae, A review of cocaine induced seizure s and treatment is included. Copyright (C) 1998 by W.B. Saunders Compa ny.