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Key Questions Introduction References
Questions Case Presentation
A 37 year old patient presents by paramedics after his father found him unresponsive with tonic-clonic seizures. The patient had recently ingested "oil of wormwood" he had purchased on the internet.
A 43 year old male has an argument with his wife. He goes to the shed in the backyard and then crawls into bed with his upset spouse. He calmly informs her that he just drank a can of "gopher-getter." She ignores him and falls asleep. One hour later, she is awakened by his seizure activity and notes he is "seizing with his eyes wide open."
Two brothers are forging through the woods with a plan to "live off the fat of the land." They arrive by a small mountain stream and discover some "wild carrot roots." They build a campfire, and cook some "wild carrot soup." 30 minutes after dinner, they are both actively seizing.
A male is found
unresponsive by state police his car which is discovered off the road,
trapped in a snow bank. There are no signs of obvious trauma. Paramedics
are called to the scene and the patient is transported to the nearest
ED. En route, the patient suffers a generalized seizure.
A four year old child presents with new onset seizure activity and is admitted to a tertiary care PICU. After an extensive work-up, no clear etiologic cause is determined. One week after admission, a compulsive medical student questions the family and discovers the child had been "force-fed dirt…"
A dermatology calls the toxicology service frantic stating his patient is actively seizing in his clinic. The patient had been undergoing "an extensive hair transplant"
Key Learning Points
Management of Toxin or Drug-Induced Seizures
1. Which of the following drugs classically results in toxic seizures in an overdose setting?
2. Which of the following toxins can result in toxin-induced seizure activity in an overdose setting?
3. Which of the following drugs is considered the "second-line" agent for treatment of toxin-induced seizures?
4. Which of the following gastric decontamination measures is contraindicated with drug overdoses which may manifest in toxic seizure activity?
5. In managing toxin-induced seizures what other clinical finding should be ruled-out or carefully considered?
1. Answer a. 2. Answer e. 3. Answer c. 4. Answer b. 5. Answer e. |