Abstracts

Rationale: Kratom is a tropical tree of the Mitragyna genus endemic to Southeast Asia that produces leaves containing psychotropic compounds. The leaves, currently legally available, produce a mild stimulant effect when smoked, chewed or consumed in low doses, comparable to the effects of cocaine. Increasing doses produce opioid-like effects, sedation and stupor. One known side effect is seizures. We present a case series of patients who presented with new-onset seizures following kratom use.

Methods: Retrospective series of 2 patients treated at a university hospital.

Results: Patient 1: A tricenarian male with a past medical history of asthma and anxiety drank kratom-infused tea from the White Vein Maeng Da strain twice daily for the past 2 years. After switching to the King Kratom strain, he experienced a witnessed generalized tonic clonic seizure after one dose. Electroencephalogram (EEG) was negative for epileptiform discharges and he returned to baseline.

Patient 2: A middle-aged male with a past medical history of hypertension and substance abuse experienced a witnessed, new onset generalized tonic-clonic seizure with associated urinary incontinence in the setting of wine, benzodiazepine and kratom use. On the scene, the patient required intubation for airway protection. EEG upon hospital arrival demonstrated generalized rhythmic delta activity with improvement throughout his stay. The patient ultimately was extubated and improved to close to baseline.

Conclusions: We present a small series of patients without a history of epilepsy who had seizures in the setting of kratom use. Due to the increasing use of this easily accessible, drug of concern, more kratom-induced seizures will likely be seen by neurologists in practice.

Funding: Please list any funding that was received in support of this abstract.: N/A.