@article{ref1,
title="Acute zonisamide overdose: a death revisited",
journal="Veterinary and human toxicology",
year="2003",
author="Sztajnkrycer, Matthew D. and Huang, E. E. and Bond, G. Randall",
volume="45",
number="3",
pages="154-156",
abstract="Overdose experience with the anti-epileptic agent zonisamide (Zonegran, ZNS) is limited. We present a case of suspected zonisamide overdose previously reported in abstract form, manifesting as seizures, dysrhythmias and death of an 18-y-o woman after single ingestion of 4.8 g ZNS in a suicide attempt. The patient experienced multiple generalized tonic-clonic seizures and copious airway secretions. En route to the emergency department, she sustained cardiopulmonary arrest from which she was resuscitated. CT scan of the head approximately 24 h after initial presentation revealed massive cerebral edema with tonsillar herniation; brain death was confirmed. Serum ZNS was 44 mg/L, and the case was officially deemed death secondary to ZNS overdose. Subsequently, a comprehensive urine drug screen demonstrated mirtazepine, diphenhydramine metabolites, and caffeine. Due to confounding factors, a definitive causal role for ZNS in this overdose death cannot be made, despite the county coroner's ruling.<p /><p>Language: en</p>",
language="en",
issn="0145-6296",
doi="",
url="http://dx.doi.org/"
}