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Cocaine Kindling

George B. Murray, MD
JAMA. 1986;256(22):3094-3095. doi:10.1001/jama.1986.03380220060017.
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To the Editor.—  The recent cocainerelated deaths of two professional athletes have again emphasized that cocaine use can be life threatening.1 Both athletes, according to the media, suffered a seizure prior to death. The possibility of a tonic-clonic seizure occurring as a result of cocaine use is well documented.2It is thought that cocaine produces its euphoric effect in limbic structures. Cocaine, like procaine, is a strong effector of kindling, which is more easily effected in the limbic system.3 A complex partial seizure is often seen in partially kindled animals before a generalized seizure is seen as the end point of kindling. For kindling to take place, an intermittent stimulus is required; most cocaine users are intermittent users.More recently, complex partial seizures have been linked to cardiac dysfunction and arrest.4,5 Since the amygdala is the limbic structure most vulnerable to kindling and since the amygdala


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