Toluwalashe Soyemi, Aremu Olusola, Ekerin Olabode, Lawal Abdulqudus, Oluwatobi Faniyi, Adebayo Victor, Akingbola Adewunmi, Olaniyan Simon, Progress Agboola, Aborode Abdullahi Tunde
Faculty of Clinical Sciences, Lagos State University College of Medicine, Lagos, Nigeria.
School of Public Health, University of Port Harcourt, Port-Harcourt, Rivers, Nigeria.
Subst Use. 2024 Nov 29;18:29768357241304298. doi: 10.1177/29768357241304298. eCollection 2024 Jan-Dec.
E-cigarettes gained popularity globally through the promotion of e-cigarettes as a risk-free way to stop traditional smoking. However, new evidence suggests that they may have a detrimental effect on the nervous system and ultimately adverse neurological manifestations. Seizures have been reported among both new and experienced e-cigarette users. In several cases, the seizure presented immediately after its use, while others reported continuous use for weeks before seizures occurred. This review presents a deeper insight into the clinical management, implications, and public health considerations of seizure susceptibility in e-cigarette users. Using recent case reports, epidemiological studies, and experimental research, we highlight the role of likely etiological mechanisms such as how nicotine's convulsive effects are linked to α7- nicotinic acetylcholine receptors (nAChRs), the varied clinical presentations, and the potential nicotine toxicity linked to seizures. Furthermore, we discuss the existing debates and controversies, diagnostic directions, and potential role in individual susceptibility to e-cigarette-associated seizures. Importantly, we address how seizures may be accompanied by both physical and psychological sequelae, which may impair the quality of life for individuals presenting for emergency care. We also address the limitations and challenges in the etiology of e-cigarette-associated seizures and the non-criteria for defining seizures caused by e-cigarettes. The review concludes with an insight into public health considerations and policy recommendations by highlighting the importance of mass awareness and clinical considerations that could guide patient management.
电子烟通过宣传其为戒烟的无风险方式而在全球范围内广受欢迎。然而，新证据表明，它们可能会对神经系统产生有害影响，并最终导致不良的神经学表现。新老电子烟使用者中均有癫痫发作的报告。在一些案例中，癫痫发作在使用电子烟后立即出现，而其他案例则报告在癫痫发作前持续使用了数周。本综述对电子烟使用者癫痫易感性的临床管理、影响及公共卫生考量进行了更深入的探讨。利用近期的病例报告、流行病学研究和实验研究，我们强调了可能的病因机制的作用，如尼古丁的惊厥作用如何与α7-烟碱型乙酰胆碱受体（nAChRs）相关联、不同的临床表现以及与癫痫发作相关的潜在尼古丁毒性。此外，我们讨论了现有的争议、诊断方向以及个体对电子烟相关癫痫易感性的潜在作用。重要的是，我们阐述了癫痫发作可能伴随的身体和心理后遗症，这可能会损害寻求急诊治疗的个体的生活质量。我们还探讨了电子烟相关癫痫病因方面的局限性和挑战以及定义电子烟所致癫痫发作的非标准。综述最后通过强调大众意识和临床考量对指导患者管理的重要性，深入探讨了公共卫生考量和政策建议。
