Toxin-related seizures.
Toxin-related seizures result from an imbalance in the brain's equilibrium of excitation-inhibition. Fortunately, most toxin-related seizures respond to standard therapy using benzodiazepines. However, a few alterations in the standard approach are recommended to ensure optimal care and expedient termination of seizure activity. If 2 doses of a benzodiazepine do not terminate the seizure activity, a therapeutic dose of pyridoxine (5 g intravenously in an adult and 70 mg/kg intravenously in a child) should be considered. Phenytoin should be avoided because it is ineffective for many toxin-induced seizures and is potentially harmful when used to treat seizures induced by theophylline or cyclic antidepressants.
Department of Emergency Medicine, Good Samaritan Hospital Medical Center, West Islip, NY 11795, USA. ansharma@pol.net
Adhi N
AN
Sharma
Robert J
RJ
Hoffman
D000241:Adenosine / Q000502:physiology; D000328:Adult; D000465:Algorithms; D000927:Anticonvulsants; D002648:Child; D019091:Critical Pathways; D004636:Emergency Service, Hospital; D006801:Humans; D007262:Infusions, Intravenous; D011736:Pyridoxine / Q000008:administration & dosage; D018079:Receptors, GABA / Q000502:physiology; D016194:Receptors, N-Methyl-D-Aspartate / Q000502:physiology; D012640:Seizures / Q000139:chemically induced* / Q000188:drug therapy / Q000503:physiopathology*; D014815:Vitamins / Q000008:administration & dosage
D000927:Anticonvulsants; D018079:Receptors, GABA; D016194:Receptors, N-Methyl-D-Aspartate; D014815:Vitamins; D000241:Adenosine; D011736:Pyridoxine