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Cefepime-induced nonconvulsive status epilepticus in a hemodialysis patient

  • Lee, Yoo Jin (Department of Internal Medicine, Inje University Haeundae Paik Hospital) ;
  • Park, Bong Soo (Department of Internal Medicine, Inje University Haeundae Paik Hospital) ;
  • Park, Kang Min (Department of Neurology, Inje University Haeundae Paik Hospital) ;
  • Kim, Il Hwan (Department of Internal Medicine, Inje University Haeundae Paik Hospital) ;
  • Park, Jin Han (Department of Internal Medicine, Inje University Haeundae Paik Hospital) ;
  • Park, Si Hyung (Department of Internal Medicine, Inje University Haeundae Paik Hospital) ;
  • Kim, Yang Wook (Department of Internal Medicine, Inje University Haeundae Paik Hospital)
  • Received : 2018.04.24
  • Accepted : 2018.06.28
  • Published : 2018.07.31

Abstract

Nonconvulsive status epilepticus (NCSE) is an unusual complication in patients treated with cefepime. An 82-year-old woman on maintenance hemodialysis was given cefepime for pneumonia. Her level of consciousness decreased since the administration of cefepime, and she was diagnosed with NCSE based on electroencephalography (EEG) findings. After discontinuation of cefepime, improvement was seen both in the level of consciousness and EEG findings. Clinicians should be aware of cefepime-induced NCSE, particularly in patients with renal failure.

Keywords

References

  1. Delanty N, Vaughan CJ, French JA. Medical causes of seizures. Lancet 1998;352:383-390. https://doi.org/10.1016/S0140-6736(98)02158-8
  2. Hirsch LJ, Gaspard N. Status epilepticus. Continuum (Minneap Minn) 2013;19:767-794.
  3. Fernandez-Torre JL, Martinez-Martinez M, Gonzalez-Rato J, Maestro I, Alonso I, Rodrigo E, et al. Cephalosporin-induced nonconvulsive status epilepticus: clinical and electroencephalographic features. Epilepsia 2005;46:1550-1552. https://doi.org/10.1111/j.1528-1167.2005.16305.x
  4. Fugate JE, Kalimullah EA, Hocker SE, Clark SL, Wijdicks EF, Rabinstein AA. Cefepime neurotoxicity in the intensive care unit: a cause of severe, underappreciated encephalopathy. Crit Care 2013;17:R264. https://doi.org/10.1186/cc13094
  5. Dakdouki GK, Al-Awar GN. Cefepime-induced encephalopathy. Int J Infect Dis 2004;8:59-61. https://doi.org/10.1016/j.ijid.2003.09.003
  6. U.S. Department of Health and Human Services. FDA Drug Safety Communication: cefepime and risk of seizure in patients not receiving dosage adjustments for kidney impairment [Internet]. Rockville (MD, USA): FDA; c2016 [accessed 2016 Jan 19]. Available from: https://www.fda.gov/Drugs/DrugSafety/ucm309661.htm.
  7. Sugimoto M, Uchida I, Mashimo T, Yamazaki S, Hatano K, Ikeda F, et al. Evidence for the involvement of GABA(A) receptor blockade in convulsions induced by cephalosporins. Neuropharmacology 2003;45:304-314. https://doi.org/10.1016/S0028-3908(03)00188-6
  8. Schliamser SE. Neurotoxicity of beta-lactam antibiotics. Experimental kinetic and neurophysiological studies. Scand J Infect Dis Suppl 1988;55:1-61.