Use of Benzodiazepines in Chemical Submission in Children: Insights From Electroencephalography and Toxicological...

This case report identifies benzodiazepine intoxication as the cause of seizures in a pediatric patient, a diagnosis that is often missed in similar clinical presentations. The recent deaths of two siblings under similar circumstances make this case particularly unique, emphasizing the need to consider toxicological causes in such contexts. Additionally, the report highlights the crucial role of EEG and advanced toxicological analysis, like high-performance liquid chromatography (HPLC), in diagnosing and managing complex cases, underscoring their importance in improving patient outcomes. We describe the case of a 12-year-old child who was admitted to the pediatric emergency department of Hassan II University Hospital in Morocco for a brief apyretic convulsive seizure with loss of consciousness. The biological analysis, brain MRI, and lumbar puncture (LP) analysis were normal. Notably, the patient had a concerning family history with the recent deaths of two younger siblings, aged five and six years, occurring 20 days apart. These deaths were preceded by similar neurological symptoms. Over several weeks, the patient continued to experience epileptic seizures. Electroencephalography (EEG) findings suggested benzodiazepine intoxication. Subsequent toxicological investigations revealed significantly elevated benzodiazepine levels in both serum and urine, confirmed by HPLC. This case underscores the critical need for considering EEG patterns and toxicological analysis in pediatric patients with unexplained seizures, particularly in the context of a suspicious family history that suggests potential child maltreatment. Early identification and confirmation of benzodiazepine intoxication can be life-saving and may prevent further tragic outcomes.