Cocaine abuse is associated with a variety of severe acute neurologic complications typically occurring in the abusers themselves. These include ischemic stroke, subarachnoid and intraparenchymal hemorrhage, headaches, syncope, seizures, and death. Sixteen pediatric patients with presumed cocaine-related seizures secondary to maternal consumption are reported. They were evaluated only because of requests for neurologic consultation. All were seen during the 1987 calendar year at the King/Drew Medical Center and Urban Comprehensive Epilepsy Program of Los Angeles. The cohort had similar maternal pregnancy histories and uniformly presented with postdelivery tremulousness, irritability, and excessive startle responses. Shortly after birth, each patient began having stereotypic episodes with ictal electroencephalographic confirmation in seven. Eight of these neonates continued to have seizures after the initial month of life.

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A 53-year-old woman with a history of chronic abuse of "crack" cocaine developed isolated complex partial status epilepticus after 3 days of frequent cocaine use. The electroencephalogram demonstrated focal epileptiform activity. Follow-up for 1 year during which she reported continuous abstinence from cocaine and anti-convulsants revealed no recurrence of seizures.