一次惊人的摄入：故意食用塑料炸药导致癫痫发作。
A Mind-Blowing Ingestion: Intentional Plastic Explosive Consumption Resulting in Seizures.
作者信息
Jones Seth, Li Irene, Gale Jasmine, Fox Elliott, Weisberg Stacy, Carreiro Stephanie
机构信息
Department of Emergency Medicine, Division of Medical Toxicology, University of Massachusetts Medical School, University Campus, 55 Lake Avenue North, Worcester, MA, 01655, USA.
Department of Emergency Medicine, University of Massachusetts Medical School, University Campus, 55 Lake Avenue North, Worcester, MA, 01655, USA.
出版信息
J Med Toxicol. 2025 Jul 10. doi: 10.1007/s13181-025-01084-7.
INTRODUCTION
C4 is a plastic explosive commonly used in military applications, and is predominantly composed of cyclonite or RDX (Royal Demolition Explosive). C4 toxicity is a documented but not commonly known cause of altered mental status and recurrent seizures.
CASE REPORTS
We describe two cases of military personnel who ingested C4 as part of a hazing ritual who presented to the emergency department with witnessed seizure, tremor and petechial rash. One of the patients had a second witnessed seizure within hours of ingestion. They were treated with intravenous benzodiazepines acutely, then with levetiracetam for 48 hours. Both patients were observed in the intensive care unit and discharged with no neurologic sequelae.
DISCUSSION
C4 is a common military-grade explosive containing cyclonite which functions as a non-competitive, reversible GABAA antagonist and a rare but clinically significant cause of altered mental status and seizures when ingested. Management is primarily supportive with airway protection and treatment with GABAergic medication.
引言
C4是一种常用于军事用途的塑性炸药，主要由旋风炸药或黑索金（皇家爆破炸药）组成。C4中毒是导致精神状态改变和反复癫痫发作的一个有文献记载但并不广为人知的原因。
病例报告
我们描述了两例军事人员的病例，他们在一种欺凌仪式中摄入了C4，随后因出现癫痫发作、震颤和瘀点性皮疹而被送往急诊科。其中一名患者在摄入C4数小时内再次出现癫痫发作。他们首先接受了静脉注射苯二氮䓬类药物的紧急治疗，然后接受了48小时的左乙拉西坦治疗。两名患者均在重症监护病房接受观察，出院时无神经后遗症。
讨论
C4是一种常见的军事级炸药，含有旋风炸药，其作用是一种非竞争性、可逆的GABAA拮抗剂，摄入后是导致精神状态改变和癫痫发作的罕见但具有临床意义的原因。治疗主要是支持性的，包括气道保护和使用GABA能药物进行治疗。
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