Cocaine causing convulsions in a large municipal hospital population

We reviewed all cases with a diagnosis of convulsions admitted to a large municipal hospital in 1 year and determined which of these patients had an additional diagnosis of ongoing cocaine use. Of 795 patients with convulsions, 29 also had a diagnosis of active cocaine use (4%). On review of these cases, only 4 (0.5%) were determined by history to possibly show a causal relationship between cocaine use and convulsions. On review of 22 cases of convulsions related to cocaine use over the past 4 years, 9 were found to have multiple convulsive episodes related to cocaine. Our findings suggest that cocaine is an infrequent cause of seizures in a city hospital population. However, there is a small number of patients in whom cocaine is apparently highly proconvulsant.