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Numerous exogenous toxins can induce seizures (see Box 3.1, Chapter 3) through different mechanisms including increased excitation, decreased inhibition, and interference with energy metabolism (O’Brien, 1998). Toxins may affect the nervous system directly or indirectly, by affecting other organs whose dysfunction secondarily affects the brain (e.g. HE due to toxin-induced hepatic failure, xylitol-induced hypoglycaemia). This chapter focuses predominantly on toxins with direct effect on the nervous system.