Cushing's Storm: A Case of Paraneoplastic Cushing's Syndrome-Induced Seizures Treated With Continuous Etomidate Infusion

A 67-year-old female presented with abdominal pain, nausea, vomiting, and unintentional weight loss. Further work-up revealed elevated serum cortisol, hypokalemia, and metabolic alkalosis in the setting of paraneoplastic Cushing's syndrome secondary to small lung cancer. The patient then developed refractory convulsive epileptic seizure despite being on multiple anti-epileptic medications. Here, we present a unique case where continuous etomidate infusion was used to lower serum cortisol, as adrenal insufficiency is associated with etomidate use. This case emphasizes how drug side effects can be used to achieve a desired treatment outcome.