Propylene Glycol Toxicity in Adolescent with Refractory Myoclonic Status Epilepticus.
Propylene glycol (PG) is a solvent commonly used in medications that, while benign at low doses, may cause toxicity in adults and children at high doses. We describe a case and the physiologic sequelae of propylene glycol toxicity manifested in a critically ill adolescent male with refractory myoclonic status epilepticus aggressively treated with multiple PG-containing medications (lorazepam, phenobarbital, and pentobarbital)-all within accepted dosing guidelines and a total daily PG exposure previously recognized to be safe. Hemodynamic measurements by bedside echocardiography during clinical toxicity are also reported. Clinicians should have a high index of suspicion for propylene glycol toxicity in patients treated with PG-containing medications even when the total PG exposure is lower than currently accepted limits.
Mayo Clinic, Rochester, MN, USA.
Kara A
0000-0001-8508-3893
KA
Bjur
Mayo Clinic, Rochester, MN, USA.
Bryan C
BC
Cannon
Mayo Clinic, Rochester, MN, USA.
Anthony L
0000-0001-5256-8368
AL
Fine
Mayo Clinic, Rochester, MN, USA.
Matthew J
MJ
Ritter
Mayo Clinic, Rochester, MN, USA.
Kerry E
KE
Schueler
Mayo Clinic, Rochester, MN, USA.
Michael E
0000-0002-6803-1765
ME
Nemergut