Seizures associated with synthetic cathinone exposures in the pediatric population

Synthetic cathinones or "bath salts" are an increasing problem in the United States. Their adverse effects are related to sympathomimetic toxicity and seizures have been listed among the side effects. This study details the seizures that occur after synthetic cathinone exposure in the pediatric population.

We used the American Association of Poison Control Centers database to capture all known synthetic cathinone exposures in children <20 years of age from January 1, 2010 through January 31, 2013. Demographic data along with signs of fever, acidosis, hallucinations and/or delusions, hypertension, tachycardia, electrolyte abnormalities, and coingested substances were collected for all synthetic cathinone users and compared with those users who experienced seizure activity.

Over the specified time period, there were 1328 pediatric synthetic cathinone exposures. Seizures complicated 73 (5.5%) of the cases, with 37 (50.7%) of those cases experiencing a single seizure, 29 (39.7%) multiple seizures, and seven (9.6%) status epilepticus. Fever and acidosis were associated with single seizures, multiple seizures, and status epilepticus. There was no correlation found between any seizure activity and electrolyte abnormalities, hallucinations and/or delusions, tachycardia, or hypertension. Coingestants were present in 33 (45%) of the seizure cases. The most commonly coingested substances were tetrahydrocannabinol, alcohol, and opioids.

Seizures complicated 5.5% of synthetic cathinone exposures in the pediatric population. Fever and acidosis were associated with seizure activity. The presence of fever after a synthetic cathinone exposure may warrant more aggressive monitoring and treatment.