Vaping and Seizure Risk: A Case Report (1814)

Objective: We report a case of new-onset seizure following vaping.

Background: A growing number of individuals are current users of e-cigarettes and vaping. There have been reports of lung injury and death following e-cigarette use. The Food and Drug Administration (FDA) recently issued an alert regarding the safety of vaping after numerous seizures were reported following its use. It remains unclear whether seizures occur due to nicotine toxicity or from other unique factors.

Design/Methods: Not Applicable

Results: We present a 34-year-old male with no past medical history who was brought to the emergency department with a new onset seizure. He was driving a vehicle when he had a generalized tonic clonic seizure lasting two minutes. The seizure was witnessed by his wife who described bilateral tonic arm extension followed by generalized convulsions, followed by a postictal state. Initial work-up included a non-contrast CT head which was normal, and lab work which showed only mild hypophosphatemia. Urine drug screen was negative. While in the ED the patient again vaped, leading to yet another generalized tonic clonic seizure minutes later. The patient was then started on levetiracetam. Further work-up included an MRI brain with and without contrast which was normal, and an EEG which was abnormal due to the presence of mild focal slowing in the left temporal region. No epileptiform features were noted and no seizures were recorded. Further history was elicited, which revealed that for months prior to the patient’s presentation he would become flushed, diaphoretic, and at times confused or agitated after vaping. He reported vaping minutes prior to getting in the car on the day when he had his first seizure.

Conclusions: E-cigarette exposure raises significant public health concerns. There may be a connection with e-cigarette exposure and seizures. Additional information is required to determine if a link exists between vaping and seizures.

Disclosure: Dr. Quezada has nothing to disclose. Dr. Sianati has nothing to disclose. Dr. Valeriano has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with UCB, Eisai, LivaNova, Sunovian.