Vaping emerges as possible trigger for seizures

There aren’t many known cases, but the few so far have fueled a federal warning

The girl shown here is being cared for during a seizure caused by epilepsy. Recently, reports have surfaced of teens developing seizures after vaping. Though sparse, the data on this are worrying.

Martinbowra/iStock/Getty Images Plus

Health experts have been growing increasingly concerned about the rising rate of teen vaping. Too many kids see e-cigarettes as cool and harmless, they note. And it’s that last part that’s especially worrisome, they say. Study after study has shown vaping does pose risks. One of the newer and more concerning symptoms: seizures.

Last April, the U.S. Center for Tobacco Products issued a special announcement. Over the past nine years, people have filed reports on 35 cases of vaping-related seizures. Most took place in the previous year. Especially worrying, it noted, most of the cases involved teens or young adults.

The center, based in Silver Spring, Md., is part of the U.S. Food and Drug Administration. “Detailed information is currently limited,” its report notes. But emerging data are so worrying, it adds, that FDA wanted to get the word out on “this important and potentially serious health issue.”

electrical brain storm
Seizures are essentially electrical storms in the brain. Little is known about the molecular changes that can trigger them. But at least in animals, nicotine can turn on such storms.peterschreiber.media/iStock/Getty Images Plus

Seizures are electrical storms in the brain. They can be accompanied by convulsions, where the body shakes uncontrollably. However, the new report notes, “not all seizures show full-body shaking.” Some people just show “a lapse in awareness or consciousness.” This might leave someone “staring blankly into space for a few seconds,” the FDA report explains. Affected people might simply stop what they’re doing, briefly. If this happens while someone is standing, they might collapse.

It’s been known that nicotine can promote seizures in some people. And the “recent uptick” among vapers signals “a potential emerging safety issue,” FDA said. 

Case reports paint disturbing picture

In June 2018, one woman reported hearing her son “crash to the floor in the room above me.” When she reached him, she told the FDA, “he was fully seizing.” She reported that he was turning blue, “with eyes rolled up in his head.” The event left the boy unconscious. He did not come to until he was on his way to the hospital. 

Paramedics had found a JUUL e-cigarette under his body.

When asked what had happened, the boy told his mom that while using the JUUL, he started seeing “an eye aura immediately, in his left eye.” It turned into what seemed to be “a dark shadow coming at him that he was trying to get away from,” she reported. Until this incident, the woman said, her son seemed “a perfectly healthy teenager with no underlying [health] issues.”

Another parent reported that her son used a JUUL device because “everyone” at his school vapes them. Even if the boy had some unknown vulnerability to seizures, the parent says, “myself and his pediatrician feel this seizure is directly related to the JUUL device and pod used. Time to fast track regulation of these devices!”

A September 2018 report by another parent described a boy who became addicted to nicotine as a result of frequent JUUL vaping. “Recently, our son had a grand mal seizure following his JUUL use.” This parent also reported that a cardiologist, or heart specialist, “believes [the boy’s] chest pains and cold sweats are connected to his JUUL use.” The parent also expressed concern about the boy’s nicotine addiction affecting his behavior and schoolwork (claiming he went from a “high achieving ‘A’ student to [a] struggling ‘F’ student”).

All these reports are anonymous. People only include as much information as they choose to. But still another report noted: “I used a JUUL e-cigarette and experienced a serious 5+ min seizure within 30 min.” Claimed this patient, until using JUUL, “I have never experienced a seizure.”

Nicotine a likely suspect, but . . . 

At least in animals, nicotine can trigger epileptic seizures. Scientists in Japan reported on that in a 2017 paper published in Frontiers in Pharmacology. The doses they needed were high. Indeed, they described “overdosing” the animals.

Might the same happen in people?

Jonathan Foulds has heard about the potential vaping links to seizures. This Penn State scientist in Hershey studies nicotine effects in smokers and vapers. “I looked at the FDA reports,” he says. And, he notes, “it’s definitely possible that nicotine — or something in e-cigarettes — can trigger seizures.” But, he cautions, no one knows that yet for certain. The few reports the FDA has were anonymous. No one can follow up to get more details. So the quality of these data, Foulds argues, “are not convincing.”

He says, “I’m open-minded about this.” Still, he points out, “for decades, kids have been using devices that give them at least as much nicotine as a JUUL, if not more.” And the name of these devices? Cigarettes. In the 1990s there were plenty of high school kids smoking daily. “Some of them were puffing away like chimneys,” Foulds quips. And, he points out, “there were not a lot of kids getting seizures.”

So he, for one, would like to see more research on the issue. 

In the meantime, FDA “encourages the public to report cases of individuals who use e-cigarettes and have had a seizure.” People can log details of the events online at its Safety Reporting Portal.

Janet Raloff is the editor of Science News for Students. Prior to this, she was an environmental reporter for Science News, specializing in toxicology. To her never-ending surprise, her daughter became a toxicologist.

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