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NEUROLOGY 1990;40:404
© 1990 American Academy of Neurology

Cocaine-induced seizures

Alvaro Pascual-Leone, MD, PhD, Anil Dhuna, MD, Irfan Altafullah, MD and David C. Anderson, MD

Department of Neurology (Drs. Pascual-Leone, Dhuna, and Altafullah), University of Minnesota, and Hennepin County Medical Center (Dr. Anderson), Minneapolis, MN.

We retrospectively studied 474 patients seen at Hennepin County Medical Center because of medical complications related to acute cocaine intoxication. Of the 474, 403 had no history of seizures. Seizures within 90 minutes of cocaine use was the primary diagnosis in 32 (7.9%) of the 403. The majority of seizures were single, generalized, induced by intravenous or "crack" cocaine, and not associated with any lasting neurologic deficits. Most that were focal, multiple, or induced by nasal cocaine were associated with an acute intracerebral complication or concurrent use of other drugs. Of 71 patients with a history of non-cocaine-related seizures, 12 (16.9%) presented with cocaine-induced seizures; most of these were multiple, of the same type as those in their history, and induced by even nasal cocaine. In the 44 cocaine-induced seizure patients, a pattern of habitual cocaine abuse was associated with diffuse brain atrophy on CT and diffuse slowing on EEG.

Address correspondence and reprint requests to Dr. Alvaro Pascual-Leone, C/O David C. Anderson, MD, Department of Neurology, Hennepin County Medical Center, 701 Park Avenue South, Minneapolis, MN 55415.

Presented in part at the 41st annual meeting of the American Academy of Neurology, Chicago, IL, April 1989.

Received May 24,1989. Accepted for publication in final form August 22,1989.






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