Abstract

We present what we believe to be the first case of status epilepticus secondary to cannabis toxicity in a 10-month-old infant.

A previously well female infant presented with a history of irritability and increasing drowsiness over several hours. She subsequently became unrousable and developed status epilepticus. The parents admitted using cannabis recreationally and reported to have found her with resin in her mouth.

She required intubation, ventilation and transfer to intensive care. Investigations ruled out structural, infective and metabolic causes. Progress was good, with withdrawal of sedation and extubation after 15 h. A full recovery was made over the following 4 days. Subsequent neurodevelopmental progress was normal. There were no further seizures. A urine sample sent for toxicology analysis subsequently revealed the presence of cannabinoids.

One per cent of the European adult population use cannabis daily. The use of “skunk” (a cross-bred species of cannabis created to increase potency and yield) has increased fivefold over the past 6 years in the UK and now accounts for 80% of street drug seizures. The delta-9-tetrahydocannabinol content, the main psychoactive ingredient in cannabis, has increased from 6% in 1995 to 14% in 2005. The high prevalence of cannabis use and increasing drug potency is a public health concern.

It is established that cannabis toxicity is harmful to children. Cases of coma, ataxia and “shaking” have been published.

We conclude that awareness of the potential of cannabis to provoke seizures and status epilepticus may inform the management of future cases.