case_images: PMC11792734_01
case_images: Electroencephalographic beta activity during bromazepam exposure and resolution post-event. A: Electroencephalography (EEG) in the patient exposed to bromazepam revealed excessive beta activity, characterized by a recording speed of 30 mm/s, sensitivity of 7 microV/mm, frequency of 30.0 Hz, and filter settings at 1.000 Hz.. B: A follow-up EEG performed post-event demonstrated a return to normal activity with no observed abnormalities under identical parameters (30 mm/s, 7 microV/mm, 30.0 Hz, 1.000 Hz).
case_images: cureus-0017-00000076940-i01.jpg
case_images: PMC11792734_01_cureus-0017-00000076940-i01.jpg
case_images: FIG1
case_images: Interestingly, a subsequent EEG showed high-frequency basal activity and increased Beta activity in all states of vigilance that can evoke a pharmacological origin (benzodiazepines), although the patient was under phenobarbital and valproate sodium, pointing towards the toxic origin of the disease (Figure 1). 
case_images: Chromatographic identification of bromazepam: sample peak and database comparison. A: Chromatogram illustrating the bromazepam peak: 1 - bromazepam with a retention time (RT) of 15.50 minutes; 2 - the internal standard "methyl-clonazepam" with an RT of 27.39 minutes.. B: Comparison of the bromazepam peak: 1 - extracted bromazepam peak from the sample; 2 - corresponding bromazepam peak from the spectral database (library).
case_images: cureus-0017-00000076940-i02.jpg
case_images: PMC11792734_01_cureus-0017-00000076940-i02.jpg
case_images: FIG2
case_images: All toxicological investigations of blood and urine samples were positive for benzodiazepines - the rapid test, enzyme-multiplied immunoassay technique (EMIT) assay, with a concentration of 71.7microg/L, and high-performance liquid chromatography with diode-array detection (HPLC-DAD) analyses revealed a high plasma peak of bromazepam, triggering the alert (Figure 2). 