Abstracts

Rationale: In 2019, the United States Food and Drug Administration publicly initiated the first known national investigation of the relationship between vaping and seizures. Since then, literature on the topic has been slowly increasing. However, there is no data on whether or not medical providers have been inquiring about vaping as a seizure-provoking factor when interacting with patients that are being assessed for a first-time seizure.

Methods: The clinical courses of two patients who presented with vaping-related seizures are described. The results of a PubMed search for vaping, seizures, and electronic cigarettes were reviewed. An anonymous survey asked thirty neurology providers from a single large academic hospital how often they inquire about vaping as a seizure-provoking factor during interactions with patients being seen for first-time seizures.

Results: In 2020, two patients with no seizure history or risk factors presented with new onset seizures within hours of vaping. Anti-epileptic drugs were prescribed each time they presented for presumed unprovoked seizures. Vaping as a seizure-provoking factor was not discussed with either patient until later in their clinical course at which time vaping-cessation and discontinuation of all anti-epileptic drugs led to no further seizures. An anonymous single-institution survey found that 19 out of 30 Neurology providers have not been asking patients being seen for first time seizure if they have been vaping.

Conclusions: Further investigations are needed to identify the pathophysiology of vaping as a provoking factor for seizures. Although reports of a potential link between vaping and seizures have increased since 2019, there is likely still a majority of medical providers who are not subjectively qualifying vaping as a potential provoking factor during interactions with patients being seen for new onset seizures. Asking patients about vaping during interactions related to first time seizures may prove to be an important part of the initial investigation on the pathophysiology of vaping as a seizure provoking factor and utility of antiepileptic drug (AED) initiation in these patients.

Funding: Please list any funding that was received in support of this abstract.: No funding was received in support of this abstract.