Severe neurological nicotine intoxication by e‐cigarette liquids: Systematic literature review
Maenia Scarpino, Tiziana Rosso, Giovanni Lanzo, Francesco Lolli, Manuela Bonizzoli, Chiara Lazzeri, Guido Mannaioni, Roberto Baronti, Francesco Fattapposta, Antonello Grippo
Abstract
Electronic cigarettes are a popular, easily purchased, alternative source of nicotine that is considered safer than conventional tobacco. However, Intentional or accidental exposure to e-liquid substances, mainly nicotine, can lead to serious, potentially fatal toxicity. Emergency and critical care physicians should keep in mind acute intoxication of this poison with a biphasic toxic syndrome. We highlight its potentially fatal outcome and suggest monitoring the adverse effects of nicotine according to a multimodal protocol integrating somatosensory evoked potentials, electroencephalography and neuroimaging data with anamnestic report and toxicological and laboratory data.