{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,17]],"date-time":"2026-06-17T23:30:36Z","timestamp":1781739036132,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T00:00:00Z","timestamp":1595894400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2020,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The use of electronic cigarettes (e\u2010cigarettes) is very common worldwide. To date, an increase of nicotine intoxication following an accidental or intentional ingestion\/injection of refill solution (e\u2010liquid) has been detected.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case<\/jats:title>\n                    <jats:p>A 23\u2010year\u2010old man presented with sudden loss of consciousness, bradycardia, and respiratory muscle paralysis after intentional ingestion of e\u2010liquid. Early clinical data, brain computed tomography, and neurophysiological tests (electroencephalogram [EEG] and somatosensory evoked potentials [SEPs]) did not show features with a poor neurological prognostic meaning of an hypoxic encephalopathy. After 4\u00a0days, the patient showed bilateral loss of the pupillary reflex, and severe and cytotoxic edema was detected on brain magnetic resonance imaging. SEPs showed a bilateral loss of cortical responses and EEG a suppressed pattern. Nine days after the onset of coma, the patient evolved toward brain death (BD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Because nicotine intoxication might cause respiratory muscle paralysis, without cardiac arrest (CA), it would be important to understand the mechanisms underlying brain damage and to take into account that the current neurological prognostic evidence for hypoxic\u2013ischemic encephalopathy, based on data from patients who all experienced CA may not be reliable. Reporting cases of nicotine intoxication through e\u2010liquid is relevant in order to improve regulatory parameters for e\u2010liquid sale.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.1744","type":"journal-article","created":{"date-parts":[[2020,7,28]],"date-time":"2020-07-28T20:20:24Z","timestamp":1595967624000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Brain death following ingestion of E\u2010cigarette liquid nicotine refill solution"],"prefix":"10.1002","volume":"10","author":[{"given":"Maenia","family":"Scarpino","sequence":"first","affiliation":[{"name":"Neurophysiopathology Unit Neuromuscular Department AOU Careggi Florence Italy"},{"name":"IRCCS Don Carlo Gnocchi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Bonizzoli","sequence":"additional","affiliation":[{"name":"Traumatic Intensive Care Unit Neuromuscolar Department AOU Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cecilia","family":"Lanzi","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Emergency Department AOU Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Lanzo","sequence":"additional","affiliation":[{"name":"Neurophysiopathology Unit Neuromuscular Department AOU Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chiara","family":"Lazzeri","sequence":"additional","affiliation":[{"name":"Traumatic Intensive Care Unit Neuromuscolar Department AOU Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Cianchi","sequence":"additional","affiliation":[{"name":"Traumatic Intensive Care Unit Neuromuscolar Department AOU Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Gambassi","sequence":"additional","affiliation":[{"name":"Clinical Toxicology Emergency Department AOU Careggi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Lolli","sequence":"additional","affiliation":[{"name":"Biomedical Science Department Mario Serio University of Florence Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9997-8564","authenticated-orcid":false,"given":"Antonello","family":"Grippo","sequence":"additional","affiliation":[{"name":"Neurophysiopathology Unit Neuromuscular Department AOU Careggi Florence Italy"},{"name":"IRCCS Don Carlo Gnocchi Florence Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,7,28]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1124\/jpet.118.247841"},{"key":"e_1_2_8_3_1","first-page":"31","article-title":"Clinical pharmacology of nicotine: Implications for understanding, preventing, and treating tobacco addiction","volume":"835","author":"Benowitz N. 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