Seizures provoked by over-the-counter cough and cold medications in an elderly patient: a case report

BackgroundSeizures are common neurological emergencies in the elderly that are frequently provoked. Geriatrics have higher rates of neurological disorders and other comorbidities that could affect seizure threshold.Case presentationAn 83-year-old male Arabic patient presented to the emergency department with an acute confusional state and urinary incontinence followed by a witnessed tonic-clonic seizure in the hospital. Thorough investigations and imaging were positive only for nonspecific magnetic resonant imaging findings with a negative electroencephalogram. The patient was diagnosed with provoked seizure due to over-the-counter cold medications that included pseudoephedrine and caffeine. He was not prescribed antiepileptic medications at discharge and did not develop subsequent seizures up to this date.ConclusionOver-the-counter cough and cold medications with sympathomimetic ingredients can be associated with provoked seizures in the elderly. Physicians should be aware of the potentially serious adverse events associated with commonly used nonprescription sympathomimetics such as pseudoephedrine and caffeine in elderly patients.

Automated summary

This is a case report of a seizure provoked by over-the-counter cold medications containing pseudoephedrine and caffeine in an 83-year-old male patient. Physicians should be aware of the potentially serious adverse events associated with commonly used nonprescription sympathomimetics in elderly patients.