Consensus Recommendations for Gastric Emptying Scintigraphy: A Joint Report of the American Neurogastroenterology and Motility Society and the Society of Nuclear Medicine

Abstract

Objective: This retrospective case series reviews clinico-pathologic findings of two patients with seizures provoked by e-cigarette use. Background: The health consequences of e-cigarette use (vaping) have recently garnered significant media attention, most notably for numerous reports of severe pulmonary pathology. There are scattered case reports of vape-induced seizures, but thus far there have been little objective data supporting this association. Design/Methods: A retrospective case series of two patients at an urban Level IV Epilepsy Center were reviewed. Demographics and relevant clinco-pathologic data including invasive electroencephalography (EEG) data from an implanted RNS are noted Results: The first case is of an 18 year-old female with no significant medical history presented with three isolated incidents of reported generalized seizures, all occurring within hours of vaping. Comprehensive examination, laboratory data, neuroimaging, and EEG data revealed no identifiable cause other than e-cigarette use, and seizures abated following cessation of e-cigarette use. The second case is of a 32 year-old male with intractable bitemporal epilepsy since age 9 on multiple anti-seizure medications, status post RNS placement, in whom RNS alerted clinicians to increased frequency of seizures. Although there are other confounders, this paper reviews the details on how seizure counts changed while monitored on RNS during the extended period of months when vaping continued and was subsequently discontinued. Conclusions: Our case series identifies two patients in whom seizures were triggered by vaping. This work supports the association with objective EEG/electrocorticographic data from an implanted RNS(Responsive NeuroStimulator). Further research is needed into the health consequences of e-cigarette use since vaping poses a major health crisis in the US and the comprehensive pathology induced or involved remains unknown at present. Disclosure: Dr. Oster has received research support from Eisai, Biogen. Dr. Tatum has nothing to disclose. Dr. Monigan has nothing to disclose. Dr. Kryzanski has nothing to disclose.