Carbamazepine intoxication complicated by status epilepticus and ventricular fibrillation in the youth ; a case report

Abstract

27-year-old man with a history of epilepsy and no risks of arrhythmias was transported to the emergency department with coma. He developed convulsive seizures in the emergency department and was still in coma. His serum carbamazepine level was 56.9µg/mL so he was hospitalized due to status epilepticus and suspicion of carbamazepine intoxication. On day 4 of hospitalization, he developed ventricular fibrillation (VF) and achieved return of spontaneous circulation after cardiopulmonary resuscitation. Ictal VF was suspected due to the presence of remarkable artifacts in the electrocardiogram monitor before the onset of VF so sudden unexpected death in epilepsy was considered.