S. Winbery et al., MULTIPLE COCAINE-INDUCED SEIZURES AND CORRESPONDING COCAINE AND METABOLITE CONCENTRATIONS, The American journal of emergency medicine, 16(5), 1998, pp. 529-533
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.