Toxic seizures are usually generalised and self-limiting and easily controlled with intravenous benzodiazepines. The most common causes of toxic seizures in Australasia are venlafaxine, bupropion, tramadol and amphetamines.
In certain poisonings, seizures herald severe intoxication and a grave prognosis unless definitive care is rapidly instituted (e.g. salicylates, theophylline, tricyclic antidepressants, chloroquine, propranolol).
Seizures of any cause are treated as a matter of priority. Prolonged seizure activity is associated with irreversible CNS injury. Secondary hypoxia and acidosis increase the susceptibility for dysrhythmias. Secondary hyperpyrexia and rhabdomyolysis may lead to dehydration, hyperkalaemia and renal failure.
References
- Kunisaki TA, Augenstein WL. Drug- and toxin-induced seizures. Emergency Medical Clinics of North America 1994; 12(4):1027-1056.
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