A Cause of status epilepticus in Turkey: Isoniazide intoxication

Abstract

In Turkey, isoniazide (INH) is widely used for the prophylaxis and treatment of tuberculosis. Acute overdose of INH may cause metabolic acidosis, repetitive seizures and coma. A 17 year old patient was admitted to our emergency clinic with generalized convulsive status epilepticus. Her initial laboratory studies revealed hyperglycemia, leucosytosis, metabolic acidosis, hypopotasemia and high creatinin kinase (CPK) levels. Her seizures continued under standard anticonvulsive therapy. As acute toxic exposure of INH was suspected, piridoxin infusion was started. Her seizures ended. She became awake, alert and responsive. On the third day, serum transaminase and CPK levels increased. As a conclusion, INH is widely used for treatment of tuberculosis in our country. That's why INH toxicity should be suspected in any patient with refractory seizures, hyperglycemia and metabolic acidosis.