Recreational drug-induced seizures in 47 patients seen at the San Francisco General Hospital between 1975 and 1987 were reported by the Division of Clinical Pharmacy and Department of Neurology, University of California, San Francisco, CA. Over the twelve year study period 49 episodes of seizures followed the use of most of the popular street drugs and were seen after ingestion, snorting, smoking and injection. The average age of the 28 men and 19 women was 27 years (range 19-42 years). The majority of patients experienced a single generalized tonic-clonic seizure but seven had multiple seizures and two developed status epilepticus. The recreational drugs were cocaine (32), amphetamines (11), heroin (7), and phencyclidine (4). A combination was responsible in 11. Seizures occurred independent of the route of administration and in both first-time and chronic abusers. Ten (21%) had prior seizures, all closely associated with drug abuse. Apart from the patient with status epilepticus, none had permanent neurologic impairment at the time of discharge from hospital. [1]

COMMENT. Although the patients in this study were adults, the possibility of drug abuse should be considered in the evaluation of infants, children and adolescents with seizures. Heroin withdrawal has been associated with seizures in neonates [2] but not in older patients. It is fortunate that seizures due to recreational drug abuse appear to be self-limiting and not associated with neurologic sequelae. Anticonvulsant treatment is usually not required.