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Seizures associated with recreational drug abuse

Division of Clinical Pharmacy, School of Pharmacy, University of California, San Francisco, CA (Dr. Alldredge)
Department of Neurology, University of California, San Francisco, CA (Drs. Lowenstein and Simon).

We retrospectively identified 49 cases of recreational drug-induced seizures in 47 patients seen at the San Francisco General Hospital between 1975 and 1987. Most patients experienced a single generalized tonic-clonic seizure associated with acute drug intoxication, but 7 patients had multiple seizures and 2 patients developed status epilepticus. The recreational drugs implicated were cocaine (32 cases), amphetamine (11), heroin (7), and phencyclidine (4). A combination of drugs was responsible in 11 cases. Seizures occurred independent of the route of administration, and occurred in both first-time and chronic abusers. Ten patients (21%) reported having had prior seizures, all with a close temporal association with drug abuse. Other than 1 patient who developed prolonged status epilepticus that caused a fixed neurologic deficit, most patients had no obvious short-term neurologic sequelae.

Address correspondence and reprint requests to Dr. Alldredge, UCSF Department of Neurology, San Francisco General Hospital, Room 4M62, Box 0870, San Francisco, CA 94143-0870.

Supported in part by National Institutes of Drug Abuse grant DA-01696.

Presented in part at the fortieth annual meeting of the American Academy of Neurology, Cincinnati, OH, April 1988.

Received November 23, 1988. Accepted for publication in final form February 13, 1989.

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