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Convulsants (Convulsant Toxidrome)

Concise toxidrome definition: Central nervous system (CNS) disinhibition or excitation (glycine or GABA antagonism, glutamate agonism), leading to generalized convulsions.

Rationale or reasoning for toxidrome decisions: The name was chosen based upon clinical relevance and accuracy as well as ease of recall. Examples of names initially considered: General convulsant toxidrome, convulsants, convulsions, and seizures nothing else.

Issues or concerns about this toxidrome: The difference between seizures and convulsions needs to be emphasized in training.

Convulsant examples of industrial chemicals and potential chemical warfare/terrorism agents: Hydrazines, TETS, picrotoxin, and strychnine.

The clinically relevant routes of exposure and types of sources: Inhalation, ingestion, and dermal.

The organ systems generally affected: Central nervous system (CNS).

The initial signs and symptoms: Refractory status epilepticus.

A progression of signs and symptoms includes: Dose-related onset of convulsions; rapidly fatal if untreated.

The underlying pathology, biological processes, or modes of action include: GABA antagonism.

Common treatment protocol, specific antidotes and key supportive measures: Benzodiazepines, barbiturates, and pyridoxine.


Source:
Report to the Toxic Chemical Syndrome Definitions and Nomenclature Workshop (PDF - 2.01 MB) (DHS, NLM, May, 2012)


Information from Other Resources


Resource Comparison Table of Resource Comparison
Information from CDC, WISER, and CAMEO
Emergency Response Safety and Health Database (CDC/NIOSH) arrow WISER (NIH/NLM) arrow CAMEO (EPA, NOAA) arrow Medical Management Guidelines for Acute Chemical Exposures (CDC/ATSDR) arrow
  • None
Chemical Emergencies (CDC) arrow

Additional Resources:

ChemIDplus - Chemical dictionary, structures, and links to many Internet resources (NIH/NLM)
Hydrazine, Tetramethylenedisulfotetramine, Picrotoxin, Strychnine

Hazardous Substances Data Bank - Comprehensive, peer-reviewed toxicology data (NIH/NLM)
Hydrazine, Picrotoxin, Strychnine


Report on Toxic Chemical Syndromes: Definitions and Nomenclature (PDF - 2.01 MB)

An Interagency Agreement between the Department of Homeland Security (DHS) Office of Health Affairs (OHA) and the National Library of Medicine led to a workshop to discuss and develop a consistent lexicon to describe toxic chemical syndromes, or toxidromes. This workshop included practitioners and experts in emergency response, emergency medicine, and medical toxicology developed names and definitions for twelve unique toxidromes that describe and differentiate the clinical signs and symptoms from exposures to chemicals. These toxidromes focus on acute signs and symptoms caused by inhalation and dermal exposures, and each toxidrome is characterized by exposure routes and sources, organs/systems affected, initial signs and symptoms, underlying mode of action, and treatment/antidotes. The toxidrome names and definitions are designed to be readily understood and remembered by users since communication in a crisis requires accurate and succinct terms that can quickly convey the health conditions of patients. These toxidromes lay the foundation for a consistent lexicon for use in CHEMM and for other uses that, if adopted widely, will improve response to chemical mass exposure incidents.

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