03.01.2020 - By Zack Olson, MD and Michael Estephan, MD
CAUTION: THESE NOTES CONTAIN SPOILERS!!!
Case Introduction
The nurse brings back a young adult male from the lobby who is having a seizure…
Initial Vitals
* Temp 98.8* HR 90* RR 10* BP 120/80* O2 92%
Critical Actions
* Verbalize ABCs on a Critical Patient* Obtain Immediate Blood Glucose Level* Give Benzodiazepine* Initiate Workup of New-Onset Seizures* Give Pyridoxine (Vitamin B6)
Final Diagnosis
Isoniazid Toxicity
Tips and Tricks
When the patient is unable to provide history, attempt to obtain the information from external sources
Additional Reading
* Isoniazid toxicity overview (Life in the Fast Lane)* Basic approach to seizures (EM Clerkship)* Basic approach to status epilepticus (EM Clerkship)* Ketamine for refractory status epilepticus (PubMed)
Corrections
Ketamine not Keppra as potential induction agent for status epilepticus (32:40)