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Acute zonisamide overdose: a death revisited.
Vet Hum Toxicol. 2003 Jun; 45(3):154-6.VH

Abstract

Overdose experience with the anti-epileptic agent zonisamide (Zonegran, ZNS) is limited. We present a case of suspected zonisamide overdose previously reported in abstract form, manifesting as seizures, dysrhythmias and death of an 18-y-o woman after single ingestion of 4.8 g ZNS in a suicide attempt. The patient experienced multiple generalized tonic-clonic seizures and copious airway secretions. En route to the emergency department, she sustained cardiopulmonary arrest from which she was resuscitated. CT scan of the head approximately 24 h after initial presentation revealed massive cerebral edema with tonsillar herniation; brain death was confirmed. Serum ZNS was 44 mg/L, and the case was officially deemed death secondary to ZNS overdose. Subsequently, a comprehensive urine drug screen demonstrated mirtazepine, diphenhydramine metabolites, and caffeine. Due to confounding factors, a definitive causal role for ZNS in this overdose death cannot be made, despite the county coroner's ruling.

Authors+Show Affiliations

Department of Pediatrics, Drug and the Poison Information Center, Children's Hospital Medical Center, Cincinnati, OH, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

12776795

Citation

Sztajnkrycer, Matthew D., et al. "Acute Zonisamide Overdose: a Death Revisited." Veterinary and Human Toxicology, vol. 45, no. 3, 2003, pp. 154-6.
Sztajnkrycer MD, Huang EE, Bond GR. Acute zonisamide overdose: a death revisited. Vet Hum Toxicol. 2003;45(3):154-6.
Sztajnkrycer, M. D., Huang, E. E., & Bond, G. R. (2003). Acute zonisamide overdose: a death revisited. Veterinary and Human Toxicology, 45(3), 154-6.
Sztajnkrycer MD, Huang EE, Bond GR. Acute Zonisamide Overdose: a Death Revisited. Vet Hum Toxicol. 2003;45(3):154-6. PubMed PMID: 12776795.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Acute zonisamide overdose: a death revisited. AU - Sztajnkrycer,Matthew D, AU - Huang,E E, AU - Bond,G R, PY - 2003/6/5/pubmed PY - 2003/7/11/medline PY - 2003/6/5/entrez SP - 154 EP - 6 JF - Veterinary and human toxicology JO - Vet Hum Toxicol VL - 45 IS - 3 N2 - Overdose experience with the anti-epileptic agent zonisamide (Zonegran, ZNS) is limited. We present a case of suspected zonisamide overdose previously reported in abstract form, manifesting as seizures, dysrhythmias and death of an 18-y-o woman after single ingestion of 4.8 g ZNS in a suicide attempt. The patient experienced multiple generalized tonic-clonic seizures and copious airway secretions. En route to the emergency department, she sustained cardiopulmonary arrest from which she was resuscitated. CT scan of the head approximately 24 h after initial presentation revealed massive cerebral edema with tonsillar herniation; brain death was confirmed. Serum ZNS was 44 mg/L, and the case was officially deemed death secondary to ZNS overdose. Subsequently, a comprehensive urine drug screen demonstrated mirtazepine, diphenhydramine metabolites, and caffeine. Due to confounding factors, a definitive causal role for ZNS in this overdose death cannot be made, despite the county coroner's ruling. SN - 0145-6296 UR - https://www.unboundmedicine.com/medline/citation/12776795/Acute_zonisamide_overdose:_a_death_revisited_ DB - PRIME DP - Unbound Medicine ER -