Which sign can occur during stimulant acute intoxication as part of a crisis?

• A. Hyperthermia
• B. Nausea
• C. Blurred vision
• D. Seizures

Answer: (D)

During stimulant acute intoxication, the brain is flooded with monoamines such as dopamine and norepinephrine, producing marked CNS excitation and autonomic overdrive. This heightened excitability lowers the seizure threshold, and a crisis state can include a seizure. Additional factors in a crisis—extreme agitation, hyperadrenergic state, hyperthermia from muscle activity, possible hypoxia, and electrolyte disturbances—further increase seizure risk. While signs like hyperthermia, nausea, or blurred vision can accompany stimulant toxicity, seizures uniquely reflect the brain's tipping point into uncontrolled electrical activity and are a recognized dangerous complication requiring urgent management.