An 18-month-old with no seizure history developed status epilepticus requiring intubation after ingesting cannabis edibles, with lab-confirmed THC levels over 500 ng/mL in urine -- the first reported case of its kind.
Parents who keep cannabis edibles at home; emergency physicians; poison control professionals; policymakers working on edible packaging regulations
First reported case of cannabis-associated status epilepticus in a toddler
What the researchers found
An 18-month-old male presented with generalized tonic-clonic seizures that recurred despite multiple benzodiazepine doses, requiring intubation and mechanical ventilation. Extensive workup (CT, MRI, lumbar puncture, infectious testing) found no alternative cause. Urine THC-COOH exceeded 500 ng/mL and serum THC-COOH was 256 ng/mL. Urine benzoylecgonine (cocaine metabolite) was also detected at 74 ng/mL. The child returned to neurologic baseline and was discharged after five days.
Why it matters
As cannabis edibles become more available through legalization, accidental pediatric ingestion cases are increasing. This appears to be the first documented case of status epilepticus (prolonged, refractory seizures) from confirmed cannabis exposure in a toddler, highlighting a potentially life-threatening outcome.
The numbers in context
Patient age: 18 months; urine THC-COOH: >500 ng/mL; serum THC-COOH: 256 ng/mL; urine benzoylecgonine: 74 ng/mL; 5-day hospitalization; required intubation and mechanical ventilation
How the study worked
Single case report of a previously healthy 18-month-old presenting with status epilepticus. Comprehensive neurological and toxicological workup performed.
What this study cannot tell us
Single case report. Cocaine metabolite was also detected, complicating attribution. Cannot prove causation from a single case. THC dose consumed is unknown.
How to read the evidence
Single case report. Establishes that the outcome is possible but cannot determine frequency or prove definitive causation, especially with cocaine co-exposure.
When this study was published
Published in 2025.
The bigger picture
Pediatric cannabis edible exposures have surged since legalization, and most result in sedation and ataxia. Status epilepticus represents a much more severe outcome that emergency departments need to recognize and consider in their differential diagnosis for unexplained pediatric seizures.
Questions still open
- Did the cocaine co-exposure contribute to the seizures? How common are severe neurological outcomes from pediatric cannabis edible ingestion? Should cannabis edible packaging regulations be strengthened to prevent child access?
Common questions
Did the child recover fully?
Could the cocaine exposure explain the seizures?
Read the original research
Status Epilepticus After an Exploratory Ingestion of Cannabis Edibles.
Cureus, 17(9), e91463
Citation
Rivera, Kevin; Adkins, Alek Q; Murray, Brian P; Hays, Hannah. (2025). Status Epilepticus After an Exploratory Ingestion of Cannabis Edibles.. Cureus, 17(9), e91463. https://doi.org/10.7759/cureus.91463
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