title: Cocaine-associated seizures and incidence of status epilepticus.
abstract: OBJECTIVE
  Acute complications from cocaine abuse are commonly treated in the emergency department (ED); one of the most consequential is status epilepticus. The incidence of this complication is not clearly defined in the prior literature on cocaine-associated sequelae. We evaluated the incidence of status epilepticus in patients with seizures secondary to suspected cocaine use.
  
  
  METHODS
  We performed a retrospective multi-center study of patients with seizures resulting from cocaine use. We identified study subjects at 15 hospitals by record review and conducted a computer-assisted records search to identify patients with seizures for each institution over a four-year period. We selected subjects from this group on the basis of cocaine use and determined the occurrence of status epilepticus among them. Data were collected on each subject using a standardized data collection form.
  
  
  RESULTS
  We evaluated 43 patients in the ED for cocaine-associated seizures. Their age range was 17 to 54, with a mean age was 31 years; 53% were male. Of 43 patients, 42 experienced a single tonic-clonic seizure and one developed status epilepticus. All patients had either a history of cocaine use or positive urine drug screen for cocaine.
  
  
  CONCLUSIONS
  Despite reported cases of status epilepticus with cocaine-induced seizures, the incidence of this complication was unclear based on prior literature. This study shows that most cocaine-associated seizures are self-limited.
authors.affiliation: Department of Emergency Medicine, Morristown Memorial Hospital, Morristown, NJ.
authors.forename: Nima
authors.initials: N
authors.lastname: Majlesi
authors.forename: Richard
authors.initials: R
authors.lastname: Shih
authors.forename: Frederick W
authors.initials: FW
authors.lastname: Fiesseler
authors.forename: Oliver
authors.initials: O
authors.lastname: Hung
authors.forename: Renato
authors.initials: R
authors.lastname: Debellonio
references.citation: Am J Emerg Med. 1998 Sep;16(5):529-33
references.pmid: 9725976
references.citation: Pediatr Emerg Care. 1990 Sep;6(3):189-90
references.pmid: 2216922
references.citation: Neurotoxicology. 1991 Fall;12(3):621-6
references.pmid: 1745445
references.citation: Psychopharmacology (Berl). 2000 Jan;148(1):74-82
references.pmid: 10663420
references.citation: Ann Emerg Med. 1989 Feb;18(2):182-6
references.pmid: 2916784
references.citation: Ann Emerg Med. 1990 Dec;19(12):1422-8
references.pmid: 2240756
references.citation: Neuropharmacology. 2007 Mar;52(3):895-903
references.pmid: 17126860
references.citation: Neurology. 1990 Mar;40(3 Pt 1):404-7
references.pmid: 2107459
references.citation: Ann Emerg Med. 1992 Jul;21(7):772-6
references.pmid: 1610031
references.citation: Epilepsia. 1996 Sep;37(9):875-8
references.pmid: 8814101
references.citation: Lancet. 2006 Jul 15;368(9531):222-9
references.pmid: 16844492
references.citation: N Engl J Med. 1998 Apr 2;338(14):970-6
references.pmid: 9521986
references.citation: Neurology. 1989 Aug;39(8):1037-9
references.pmid: 2788249
references.citation: Eur J Pharmacol. 2003 Aug 8;474(2-3):217-22
references.pmid: 12921865