Cimetidine-related neurotoxicity may be characterized by signs of affective dysfunction, toxic delusional state and/or delirium, confusion and/or amnestic signs, coma, epileptic phenomena and focal neurological signs. EEG features are rarely mentioned in the literature. They are discussed here in a patient presenting with cimetidine-related mental impairment and epileptic seizures. Some of the clinical signs are related to our incomplete understanding of the neurotransmitter function of histamine in the brain. It is suggested that transient functional deafferentiation of the cortex may occur with chemical histamine receptor blockade at brain stem level. EEG monitoring may be helpful in patients at risk.
B. van Sweden, H. Kamphuisen