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Vaping Seizures

In August 2019, the U.S. Food and Drug Administration said it found 127 reports of seizures and other neurological symptoms, including fainting and tremors, related to e-cigarette users from 2010 to 2019. Most of the seizures occurred in young people.

The FDA first warned the public about the link between seizures and vaping in April 2019. The seizures occurred after a few puffs or up to one day after use, the agency said. The seizures happened in both first time and experienced users.

Some of the cases mentioned seizures in relation to other substances such as amphetamines or marijuana. The agency is investigating the link between seizures and vaping and trying to gather data on brands used.

Known e-cigarette side effects include headaches, nausea, nicotine addiction and lung problems.

So far, there is no definitive evidence linking e-cigarettes to seizures. But some studies have linked vaping to serious lung injuries such as e-cigarette or vaping product-use associated lung injury (EVALI), bronchiolitis obliterans organizing pneumonia (BOOP) and bronchiolitis obliterans (popcorn lung).

Researchers aren’t sure if nicotine toxicity or some other ingredients in vaping liquids are to blame for the seizures. Experts agree more study is needed.

Nicotine Overdose and Seizures

Nicotine can cause seizures in high doses, according to Dr. Neal L. Benowitz’s 2020 article in Journal of Adolescent Health.

“A nicotine overdose can cause seizures, and nicotine can cause seizures in some animal models of epilepsy. Seizures have been observed in adults who were poisoned with nicotine and in young children who have consumed liquid nicotine, including nicotine-containing e-liquids,” Benowitz wrote.

While it’s more common in children, adults may also suffer from overdose. Symptoms of a serious nicotine poisoning include rapid heart rate, vomiting, confusion, seizures and respiratory failure. These symptoms can occur in as little as 15 minutes.

Some vape pods contain more nicotine than others, and people might not be aware of the amount of nicotine they are ingesting. For example, Juul’s five percent pods contain as much nicotine as a pack of cigarettes, and e-cigarettes can deliver nicotine to the brain in about 10 seconds.

But Benowitz said there is not yet enough evidence to say that nicotine in e-cigarettes causes seizures.

“At this point in time, I would not consider seizures to be a potential adverse effect that should influence the decision of an adult smoker to use e-cigarettes to try to stop smoking conventional cigarettes,” he wrote.

How Nicotine Increases Seizure Risk

Seizures occur when the brain has a sudden, uncontrolled electrical disturbance. They can cause changes in movement, feelings and behavior. Researchers think nicotine may cause seizures by activating neurons in the brain.

In a 2017 animal study by Higor A. Iha and colleagues published in Frontiers in Pharmacology, researchers found that nicotine may cause seizures by activating neurons in the amygdala. Data from a 2011 animal study by Dr. Nimisha Sood and colleagues published in Nicotine and Tobacco Research showed that nicotine may increase the risk of breakthrough seizure attacks in people with epilepsy.

The FDA encourages people to report any incidents of seizures connected to e-cigarettes.

“Additional reports or more detailed information about these incidents are vital to help inform our analysis and may help us identify common risk factors and determine whether any specific e-cigarette product attributes, such as nicotine content or formulation, may be more likely to contribute to seizures,” the FDA said in its April 2019 announcement.

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Reports of Seizures After Using Juul

The FDA collected some reports from parents of teens who suffered seizures after using Juul.

In one report sent to the FDA in June 2018, a mother reported that her 16-year-old son suffered a grand mal seizure after using Juul Cool Mint at five percent nicotine strength. The teen’s pediatrician suspected the seizure was related to Juul and the pod used.

“I reached him as he was fully seizing, convulsions, turning blue, eyes rolled up in his head. He was unconscious once the convulsions stopped about a minute after they probably started,” she reported. “Paramedics found the Juul device underneath him and when I asked him about it at the hospital, he admitted using it right before the seizure.”

In another report from January 2019, a parent said their 15-year-old daughter suffered a 2 to 5 minute seizure after she “hit a JUUL a handful of times in a short period.”

“There are no warning labels notifying consumers of the possibilities of nicotine overdose. This is not the first incident of seizures that has been a problem,” the parent said.

It isn’t just teens suffering seizures. Dr. Timothy Quesada and colleagues reported a vaping seizure case in April 2020. The patient was a 34-year-old man who had a tonic-clonic seizure lasting two minutes.

Litigation

People who used Juul and suffered seizures, nicotine addiction and other health problems have filed lawsuits against Juul Labs, Altria Group and Philip Morris USA, Inc.

Erin and Jared NesSmith filed a class action lawsuit against Juul and its makers in April 2019. The parents claim their daughter became addicted to Juul, and she suffers from seizures. According to the lawsuit, she also unintentionally swallowed vape juice while using the e-cigarette.

“Health authorities consider youth e-cigarettes use an epidemic,” the lawsuit said. “Defendants are to blame. Mimicking Big Tobacco’s past marketing practices, Defendants prey on youth to recruit replacement smokers for financial gain.”

There are 917 federal lawsuits pending in California federal court as of August 17, 2020.

Please seek the advice of a medical professional before making health care decisions.

Michelle Llamas, Senior Content Writer
Written By Michelle Llamas Senior Writer

Michelle Llamas has been writing articles and producing podcasts about drugs, medical devices and the FDA for seven years. She specializes in fluoroquinolone antibiotics and products that affect women’s health such as Essure birth control, transvaginal mesh and talcum powder. Michelle collaborates with experts, including board-certified doctors, patients and advocates, to provide trusted health information to the public. Some of her qualifications include:

  • American Medical Writers Association (AMWA) Engage Committee and Membership Committee member
  • Centers for Disease Control and Prevention (CDC) Health Literacy certificates
  • Original works published or cited in The Lancet, British Journal of Clinical Pharmacology and the Journal for Palliative Medicine
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10 Cited Research Articles

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  1. American College of Medical Toxicology. (n.d.). Nicotine. Retrieved from https://www.acmt.net/Nicotine.html#Q3
  2. Benowitz, N.L. (2020). Seizures After Vaping Nicotine in Youth: A Canary or a Red Herring? Retrieved from https://www.jahonline.org/article/S1054-139X(19)30525-7/pdf
  3. Iha, H.A. et al. (2017). Nicotine Elicits Convulsive Seizures by Activating Amygdalar Neurons. Retrieved from https://www.frontiersin.org/articles/10.3389/fphar.2017.00057/full
  4. NesSmith et al. v. Juul Labs Inc. et al. (2019, April 15). Class Action Complaint, Demand for Jury Trial. Retrieved from https://tobacco.ucsf.edu/sites/g/files/tkssra4661/f/wysiwyg/Juul%20lawsuit%20-%20Florida%20April%202019.pdf
  5. Quezada, T. et al. (2020, April 14). Vaping and Seizure Risk: A Case Report (1814). Retrieved from https://n.neurology.org/content/94/15_Supplement/1814
  6. Sood, N. et al. (2011). Nicotine Reversal of Anticonvulsant Action of Topiramate in Kainic Acid–Induced Seizure Model in Mice. Retrieved from https://academic.oup.com/ntr/article-abstract/13/11/1084/1082715
  7. U.S. Food and Drug Administration. (2019, April 10). Some E-cigarette Users Are Having Seizures, Most Reports Involving Youth and Young Adults. Retrieved from https://www.fda.gov/tobacco-products/ctp-newsroom/some-e-cigarette-users-are-having-seizures-most-reports-involving-youth-and-young-adults
  8. U.S. Food and Drug Administration. (2019, August 7). FDA In Brief: FDA encourages continued submission of reports related to seizures following e-cigarette use as part of agency’s ongoing scientific investigation of potential safety issue. Retrieved from https://www.fda.gov/news-events/fda-brief/fda-brief-fda-encourages-continued-submission-reports-related-seizures-following-e-cigarette-use
  9. U.S. Food and Drug Administration. (n.d.). Safety Reporting Portal. Retrieved from https://www.fda.gov/media/122794/download
  10. United States Judicial Panel on Multidistrict Litigation. (2020, August 17). MDL Statistics Report - Distribution of Pending MDL Dockets by District. Retrieved from https://www.jpml.uscourts.gov/sites/jpml/files/Pending_MDL_Dockets_By_District-August-17-2020.pdf
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