[Onset of convulsive crises with theophylline therapy at therapeutic doses]

Six patients treated with theophylline, including five with advanced chronic obstructive pulmonary disease, developed generalized seizures with serum theophylline concentrations ranging from 7 to 21 mg/l. Cerebral computed tomographic scans showed a small sylvian infarction in one patient. In the other five patients nothing, except theophylline, could account for the seizures. There were no clinical signs of theophylline toxicity prior to the failures, all of which had a favourable outcome. Patients with acute exacerbations of chronic obstructive pulmonary disease seem to be prone to develop generalized seizures when treated with theophylline.