E-Cigarette Use may lead to Seizures,warns FDA

The Food and Drug Administration (FDA) has warned the public that cases of seizures have been reported following the use of e-cigarettes.

Seizures result from sudden, abnormal electrical activity in the brain. Though often associated with convulsions in which a person’s entire body shakes uncontrollably, not all seizures show full-body shaking. Other possible signs of seizures include a lapse in awareness or consciousness, which may look like a person is staring blankly into space for a few seconds or suddenly stops moving. The person may or may not fall down. Most seizures end in a few seconds or minutes, and the person may seem fine, sleepy, confused or have a headache afterward. They may not remember what they were doing or what happened right before the seizure. While seizures generally do not cause lasting harm, they indicate the need for prompt medical attention to look for a cause and to prevent future seizures, if possible.

Seizures have previously been linked with nicotine poisoning and have been reported in the literature following ingestion of nicotine e-liquids. An FDA review of voluntary adverse event reports of these products found 35 cases of seizures following the use of e-cigarettes between 2010 to early 2019.

“We want to be clear that we don’t know yet if there’s a direct relationship between the use of e-cigs and risk of seizure,” said FDA Commissioner Scott Gottlieb, in an appearance before the House Appropriations Subcommittee.

The FDA has become aware that some people who use e-cigarettes have experienced seizures, with most reports involving youth or young adult users. Seizures or convulsions are known potential side effects of nicotine toxicity and have been reported in the scientific literature in relation to intentional or accidental swallowing of e-liquid. However, a recent uptick in voluntary reports of adverse experiences with tobacco products that mentioned seizures occurring with e-cigarette use (e.g., vaping) signal a potential emerging safety issue

Most of the reports received do not provide enough information to make clear connections between the products and seizures; there is no mention of specific brands of e-cigarettes, and in some cases, the seizures occurred when other substances (marijuana, amphetamines) were being used. In some of the reports, users mentioned a prior history of seizure diagnosis.

To help gather more information, the FDA is asking the public to report unexpected health or product issues to the Safety Reporting Portal. “We need more information before we can determine if there’s, in fact, a link between e-cigarette use and the reported incidents,” said Gottlieb. “It’s our hope that these public steps to solicit additional reports of adverse events, along with other agency efforts, will allow us to understand whether there’s a connection.”