A case of status epilepticus developed after Alpha Lipoic Acid intake

Abstract

Introduction: Alpha Lipoic Acid (ALA) is an antioxidant used in diabetic neuropathy. It is not prescribed to children. However, rarely, intoxication may occur due to accidental or suicidal intake. Case report: A 16-month-old child presented with confusion after taking 1800 mg of ALA. Convulsions that did not respond to midazolam and levetiracetam started in the emergency room. He was admitted to the intensive care unit and was intubated. Convulsions could be controlled with intravenous Ketamine infusion. He received mechanical ventilation support for five days. Gastrointestinal bleeding developed during follow-up and was treated with pantoprazole. There were laboratory measurements consistent with metabolic acidosis. Central nervous system imaging and cerebrospinal fluid examinations were normal. Electroencephalograms taken under elective conditions were reported as normal for his age. He was discharged on the twelfth day of his hospitalization. Conclusion: Children and adults with suspected ALA intake should be referred to tertiary healthcare facilities as soon as possible. In the first stage, gastric lavage and activated charcoal should be applied. Since there is no specific antidote, it should be prepared to deal with resistant convulsions, metabolic acidosis, and multi-organ failure in addition to general supportive therapy.