Fatal ascending tonic-clonic seizure syndrome.
A fatal case of ascending tonic-clonic seizure (ATCS) syndrome resulted from the inadvertent, unrecognized use of a hyperosmolar ionic contrast agent during myelography. The patient presented with lower-extremity myoclonic jerking, agitation, hyperthermia, rhabdomyolysis, and disseminated intravascular coagulation. Emergency physicians must be cognizant of this unique toxidrome to initiate early, aggressive care.
Dunford
J
J
Department of Emergency Medicine, University of California, San Diego Medical Center, San Diego, CA. jdunford@ucsd.edu
D003287:Contrast Media / Q000008:administration & dosage / Q000506:poisoning*; D003951:Diagnostic Errors; D003973:Diatrizoate / Q000008:administration & dosage / Q000506:poisoning*; D004829:Epilepsy, Generalized / Q000139:chemically induced* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007278:Injections, Spinal; D019300:Medical Errors; D008875:Middle Aged
D003287:Contrast Media; D003973:Diatrizoate