Seizures, illicit drugs, and ethanol

Abstract

Seizures can occur in recreational drug users by indirect mechanisms, including CNS -infection, ischemic or hemorrhagic stroke, cerebral trauma, or metabolic derangements such as hypoglycemia, hyponatremia, or renal failure. With some drugs, seizures are a feature of acute toxicity. Cocaine-induced seizures often occur without other evidence of toxicity; seizures in users of other psychostimulants-such as methamphetamine or methylenedioxymethamphetamine (ecstasy)-are usually accompanied by additional signs of overdose. Sedative drugs and ethanol cause seizures as a withdrawal phenomenon, but ethanol-related seizures appear to be of more than one type, some lacking a close temporal relationship to withdrawal. Clinicians should consider substance abuse when dealing with unexplained seizures and should consider seizures when encountering unusual symptoms in recreational drug users.