Severe neurological nicotine intoxication by e-cigarette liquids: Systematic literature review

Maenia Scarpino, Tiziana Rosso, Giovanni Lanzo, Francesco Lolli, Manuela Bonizzoli, Chiara Lazzeri, Guido Mannaioni, Roberto Baronti, Francesco Fattapposta, Antonello Grippo

Research output: Contribution to journalReview articlepeer-review


Electronic cigarettes are a popular, easily purchased, alternative source of nicotine that is considered safer than conventional tobacco. However, Intentional or accidental exposure to e-liquid substances, mainly nicotine, can lead to serious, potentially fatal toxicity. Emergency and critical care physicians should keep in mind acute intoxication of this poison with a biphasic toxic syndrome. We highlight its potentially fatal outcome and suggest monitoring the adverse effects of nicotine according to a multimodal protocol integrating somatosensory evoked potentials, electroencephalography and neuroimaging data with anamnestic report and toxicological and laboratory data.

Original languageEnglish
JournalActa Neurologica Scandinavica
Publication statusPublished - Sep 2020


  • brain death
  • cardiac arrest
  • e-cigarettes
  • e-liquid
  • hypoxic–ischaemic encephalopathy
  • intoxication
  • neurological prognostication
  • nicotine

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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