Toxic doses of mexiletine cause seizures in animal models and cases of seizures after mexiletine overdose have been described . When toxic levels of mexiletine were detected, the clinician finally realized that this case likely represented a serious suicidal attempt.
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However, one should be very careful in choosing the right test. Immunoassays for urine drug screening are rapid and inexpensive ; they are the most commonly used tests for drug abuse.
The differential diagnosis of seizures in an adolescent is broad and the history of seizures in the past may lead the physician not to repeat a thorough investigation. However, when a patient presents with status epilepticus, the clinician must always ask what went wrong.
The presence of mexiletine in his plasma was verified by automated HPLC, but quantitative levels were not yet available. Arrangements were made for follow-up with neurology and adolescent medicine clinics. The presence of mexiletine in the plasma raises concern. Mexiletine is a class 1B antiarrhythmic agent similar to lido-caine. Mexiletine overdose can cause seizures and may […]
The patient continued to have hallucinations, which gradually subsided over the next 24 h. There were no focal neurological deficits. The patient denied taking amphetamines. An electroencephalogram was performed at the postictal period and showed some epileptiform activity in the frontal region; no further seizures were recorded. He was started on carba-mazepine at 200 mg […]
The patient’s vital signs and glucose levels remained stable. He did not have any more seizures; however, he experienced episodes of agitation and hallucinations for which he was treated with diazepam up to a total dose of 50 mg. Urine toxic screen by fluorescence polarization immunoassay (Abbott AxSYM system, Abbott Laboratories, Saint-Laurent) was positive for […]
The boy was treated with intravenous phenytoin. The seizures stopped after 1 h. Serum osmolality was measured 2.5 h after the initial blood tests and was 323 mmoL/kg (osmolal gap = 26 mmoL/kg). The patient’s ethanol level was 14.2 mmol/L; methanol and ethylene glycol were undetected, as were acetaminophen and salicylates. buy levaquin online