An unusual case of focal seizures after a therapeutic dose of isoniazid: a case report

Submitted: 29 October 2024
Accepted: 2 January 2025
Published: 16 January 2025
Abstract Views: 1345
PDF: 35
Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

Authors

Tuberculosis remains a major cause of morbidity in endemic areas. Isoniazid (INH) is an important first-line agent for its treatment. Its major adverse effects include hepatotoxicity and neurotoxicity. Neurological side effects usually occur at toxic doses; however, few cases have reported generalized seizures at therapeutic doses. Focal seizures after therapeutic doses are rare. Here, we present the case of a 78-year-old male diagnosed with squamous cell carcinoma of the lung and pulmonary tuberculosis who experienced focal seizures after INH administration. No structural, metabolic, or infectious cause was found. The seizures stopped after discontinuation of the drug, which confirmed the diagnosis.

Dimensions

Altmetric

PlumX Metrics

Downloads

Download data is not yet available.

Citations

World Health Organization – Eastern Mediterranean Region Office (WHO-EMRO). Pakistan. Tuberculosis programs. Available from: https://www.emro.who.int/pak/programmes/stop-tuberculosis.html
Blumberg HM, Burman WJ, Chaisson RE, Daley CL. American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America: treatment of tuberculosis. Am J Respir Crit Care Med 2003;167:603. DOI: https://doi.org/10.1164/rccm.167.4.603
Tsubouchi K, Ikematsu Y, Hashisako M, et al. Convulsive seizures with a therapeutic dose of isoniazid. Intern Med 2014;53:239-42. DOI: https://doi.org/10.2169/internalmedicine.53.1303
Puri MM, Kumar L, Vishwakarma PD, Behera D. Seizures with single therapeutic dose of isoniazid. Indian J Tuberc 2012;59:100-2
Navalkele B, Bueno Rios MX, Wofford JD, et al. Seizures in an immunocompetent adult from treatment of latent tuberculosis infection: is isoniazid to blame? Open Forum Infect Dis 2020;7:ofaa144. DOI: https://doi.org/10.1093/ofid/ofaa144
Aishwarya TV. A therapeutic dose of isoniazid induced seizure episode. PTB Reports 2018;4. DOI: https://doi.org/10.5530/PTB.2018.4.4
Aiwale AS, Patel UA, Barvaliya MJ, et al. Isoniazid induced convulsions at therapeutic dose in an alcoholic and smoker patient. Curr Drug Saf 2015;10:94-5. DOI: https://doi.org/10.2174/1574886309666140930151343
Asnis DS, Bhat JG, Melchert AF. Reversible seizures and mental status changes in a dialysis patient on isoniazid preventive therapy. Ann Pharmacother 1993;27:444-6. DOI: https://doi.org/10.1177/106002809302700410
Mohammad L, Doya L, Omran R et al. An unusual case of seizures in a 5-year-old Syrian female with abdominal tuberculosis: an isoniazid therapeutic dose side effect. Oxf Med Case Reports 2021;2021:omaa126. DOI: https://doi.org/10.1093/omcr/omaa126
Hartwig SC, Siegel J, Schneider PJ. Preventability and severity assessment in reporting adverse drug reactions. Am J Hosp Pharm 1992;49:2229-32. DOI: https://doi.org/10.1093/ajhp/49.9.2229
World Health Organization - Uppsala Monitoring Center (WHO-UMC). The use of the WHO-UMC system for standardised case causality assessment. Available from: http://www.WHO-UMC.org/graphics/4409.pdf

How to Cite

Ausaf, R., waheed, S. Z., & Rehman, A. U. (2025). An unusual case of focal seizures after a therapeutic dose of isoniazid: a case report. Chest Disease Reports, 13(1). https://doi.org/10.4081/cdr.13.13317