Delayed-Onset Seizure in a Mild Quetiapine Overdose: Report of a Case and Review of the Literature

Among atypical antipsychotics, quetiapine is commonly prescribed and considered to have a favorable side effect and safety profile. Here, we report the case of a patient who developed a generalized tonic-clonic seizure 28 hours following ingestion of 1,400 mg of quetiapine. Review of the literature identifies delayed-onset seizure as a potential complication of quetiapine overdose. Unique to this case, delayed-onset seizures occurred in a patient with a relatively low dose of quetiapine and no obvious toxidrome, suggesting that this reaction may be an important consideration in the management of quetiapine overdose. The pharmacokinetics and pharmacodynamics of quetiapine may explain this unusual phenomenon.

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Acute neurogenic pulmonary oedema following generalized tonic clonic seizure. A case report and a review of the literature

European Heart Journal ◽

10.1093/oxfordjournals.eurheartj.a062590 ◽

1988 ◽

Vol 9 (8) ◽

pp. 933-936 ◽

Cited By ~ 13

Author(s):

U. FREDBERG ◽

H. E. BøTKER ◽

F. K. RøMER

Keyword(s):

Case Report ◽

Pulmonary Oedema ◽

Clonic Seizure ◽

Tonic Clonic Seizure ◽

Review Of The Literature ◽

Neurogenic Pulmonary Oedema

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Obsessive compulsive symptoms in patients with primary generalized and partial onset epilepsy

International Journal of Research in Medical Sciences ◽

10.18203/2320-6012.ijrms20181019 ◽

2018 ◽

Vol 6 (4) ◽

pp. 1183

Author(s):

Sagar Lavania ◽

Mohd. Aleem Siddiqui ◽

Shantanu Bharti ◽

Abhishek Kumar

Keyword(s):

Clonic Seizure ◽

Tonic Clonic Seizure ◽

Seizure Type ◽

Check List ◽

Onset Seizure ◽

Obsessive Compulsive ◽

Obsessive Compulsive Symptoms ◽

Partial Onset Seizure ◽

The Mean ◽

Patients With Epilepsy

Background: To find out and compare the obsessive-compulsive symptoms / disorder among patients of primary generalized and partial onset epilepsy.Methods: Patients with epilepsy diagnosed clinically at psychiatric out patient’s department were selected for the study and categorized as primary generalized onset tonic clonic seizure type and partial onset seizure. Yale-Brown obsessive-compulsive symptoms check list and scale was applied to find out the obsessive-compulsive symptoms.Results: A total of 110 patients were categorized as primary generalized (GE) 49 and partial onset epilepsy (PE) 61 patients. Obsessive-Compulsive Symptoms (OCS) were found to be 19.9%, and OCD among 3.63%. Mean Y-BOCS scores for obsession were found to be 3.77±1.93 and 4.93±2.03, (t = -3.034, df= 108, p= .003). Whereas the mean Y-BOCS compulsions score was 2.93±1.96 and 4.62±1.87 was (t = -4.590, df= 108, p= .000) for GE and PE group respectively.Conclusions: OCD and OCS among the epilepsy patients were found to be 3.63%, and 19.9% respectively, and significantly higher mean obsessive and compulsive score were found for the group of partial onset epilepsy.

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Fluoxetine overdose in a teenager resulting in serotonin syndrome, seizure and delayed onset rhabdomyolysis

BMJ Case Reports ◽

10.1136/bcr-2018-225529 ◽

2018 ◽

pp. bcr-2018-225529 ◽

Cited By ~ 2

Author(s):

Richard Lee-Kelland ◽

Sabeeka Zehra ◽

Pradeesh Mappa

Keyword(s):

Creatine Kinase ◽

Young Adult ◽

Muscle Pain ◽

Serotonin Reuptake ◽

Serotonin Syndrome ◽

Clonic Seizure ◽

Tonic Clonic Seizure ◽

Intravenous Fluids ◽

Delayed Onset ◽

Fluoxetine Overdose

A 14-year-old young adult took an overdose of 1.2 g of fluoxetine, a selective serotonin reuptake inhibitor (SSRI) that he had been prescribed for depression. He had a generalised tonic/clonic seizure at 6 hours postingestion.After the seizure, he developed signs consistent with serotonin syndrome: fine tremor, agitation, sweating and hyperreflexia. This was followed by severe muscle pain and rhabdomyolysis with peak creatine kinase (CK) of 33 941 at 74 hours. He was managed with intravenous fluids and analgesia and discharged after 4 days, having avoided renal injury. The use of SSRI’s such as fluoxetine in teenagers has increased in recent years. While it is generally considered benign in overdose, this report illustrates the severe consequences of overdose at high quantities and discusses appropriate management in these cases. We note that in this case, there was a delayed onset of rhabdomyolysis with peak CK at 74 hours postingestion.

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Tonic-Clonic Seizure following Cytoreductive Surgery with Intraperitoneal Oxaliplatin: A Case Report and Review of the Literature

Case Reports in Oncology ◽

10.1159/000443827 ◽

2016 ◽

Vol 9 (1) ◽

pp. 89-94 ◽

Cited By ~ 3

Author(s):

Jessica Sayuri Tsukamoto ◽

Marcos Belotto de Oliveira ◽

Renata D'Alpino Peixoto

Keyword(s):

Case Report ◽

Peritoneal Carcinomatosis ◽

Cytoreductive Surgery ◽

Mortality Rates ◽

Clonic Seizure ◽

Tonic Clonic Seizure ◽

Morbidity And Mortality ◽

Review Of The Literature

Cytoreductive surgery (CRS) with hyperthermic intraperitoneal (IP) chemotherapy (HIPEC) is believed to improve outcomes in well-selected patients with peritoneal carcinomatosis. However, morbidity and mortality rates associated with this procedure are substantial. Here, we describe the case of a previously healthy young man who underwent CRS with hyperthermic IP oxaliplatin and developed one episode of tonic-clonic seizure on the second postoperative day.

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New-Onset Seizure Associated with Quetiapine and Olanzapine

Annals of Pharmacotherapy ◽

10.1345/aph.1a207 ◽

2002 ◽

Vol 36 (3) ◽

pp. 437-439 ◽

Cited By ~ 30

Author(s):

Dawson W Hedges ◽

Kreg G Jeppson

Keyword(s):

Risk Factors ◽

White Woman ◽

Atypical Antipsychotics ◽

Low Dose ◽

Case Reports ◽

Seizure Threshold ◽

Onset Seizure ◽

Case Summary ◽

New Onset

OBJECTIVE: To report a case involving a witnessed seizure in a patient receiving concurrent olanzapine and quetiapine. CASE SUMMARY: A 27-year-old white woman was observed to have a seizure while receiving a stable dosage of olanzapine 15 mg/d, with the addition of quetiapine 100 mg in the evening 1 day before the occurrence of the seizure. There were no known risk factors for epilepsy. DISCUSSION: This case reports a new-onset seizure in the context of concurrent olanzapine and quetiapine use. Interpretation is complicated by recent discontinuation of low-dose clonazepam. CONCLUSIONS: While uncommon, seizures can occur with non-clozapine atypical antipsychotics. Caution is indicated when using these drugs with other agents that may lower the seizure threshold.

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The Efficacy and Safety of Conventional and Atypical Antipsychotics in First-Episode Schizophrenia: A Review of the Literature

Clinical Schizophrenia & Related Psychoses ◽

10.3371/csrp.1.1.2 ◽

2007 ◽

Vol 1 (1) ◽

pp. 27-42 ◽

Cited By ~ 3

Author(s):

Nina Schooler

Keyword(s):

Atypical Antipsychotics ◽

First Episode ◽

Efficacy And Safety ◽

Review Of The Literature ◽

First Episode Schizophrenia

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Mutational analysis of SCN2B, SCN3B and SCN4B in a large Chinese Han family with generalized tonic–clonic seizure

Neurological Sciences ◽

10.1007/s10072-010-0390-6 ◽

2010 ◽

Vol 31 (5) ◽

pp. 675-677 ◽

Cited By ~ 1

Author(s):

Yang Lu ◽

Weihua Yu ◽

Zhiqin Xi ◽

Zheng Xiao ◽

Xiaoqin Kou ◽

...

Keyword(s):

Mutational Analysis ◽

Clonic Seizure ◽

Tonic Clonic Seizure ◽

Chinese Han

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Ascending Tonic Clonic Seizure Syndrome after Percutaneous Vertebroplasty

Case Reports in Orthopedics ◽

10.1155/2015/870810 ◽

2015 ◽

Vol 2015 ◽

pp. 1-4

Author(s):

Guido Zarattini ◽

Adam Farrier ◽

Federico Sibona

Keyword(s):

Percutaneous Vertebroplasty ◽

Rare Complication ◽

Cement Leakage ◽

Clonic Seizure ◽

Tonic Clonic Seizure ◽

Leg Pain ◽

Compression Fractures ◽

First Case ◽

Seizure Syndrome ◽

Osteoporotic Compression Fractures

Background Context. Cement leakage is not a rare complication of vertebroplasty, but ascending tonic clonic seizure syndrome is exceptionally rare. We herein report the first case to our knowledge of this complication related to vertebroplasty.Purpose. We herein report the first case of ascending tonic clonic seizure syndrome following epidural cement leakage after percutaneous vertebroplasty in a patient with multiple osteoporotic compression fractures.Study Design. Case report.Methods. A 64-year-old woman with T8, T10, L2, and L4 osteoporotic compression fractures underwent percutaneous vertebroplasty using polymethylmethacrylate. 40 minutes after the procedure the patient started suffering back and leg pain, having repetitive myoclonic jerks lasting 15 seconds of the lower extremities, spasm of the back, dyspnea, sinus tachycardia, hypoxemia, and metabolic acidosis.Results. The patient recovered completely due to a combination of early effective resuscitation and considered definitive management.Conclusions. Percutaneous vertebroplasty with polymethylmethacrylate is relatively safe but has few dangerous complications, which should be prevented by a meticulous technique and excellent image quality.

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