Ozturk Savas, Kocabay Gonenc, Topcular Baris, Yazici Halil, Cagatay Arif Atahan, Bahat Gulistan, Baykan Betul, Turkmen Aydin, Yildiz Alaattin
Division of Nephrology, Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey.
Haseki Egitim ve Arsatirma Hastanesi, Ic Hastaliklari, 5. dahiliye servisi, Haseki, Fatih, Istanbul, Turkey.
Clin Exp Nephrol. 2009 Apr;13(2):138-144. doi: 10.1007/s10157-008-0115-9. Epub 2008 Dec 17.
Non-convulsive status epilepticus (NCSE): a condition that may be associated with different levels of altered consciousness without any apparent motor signs. There are published reports that it may be associated with antibiotic use patients with renal failure.
This is a retrospective analysis of our 12 NCSE (2 men, 10 women, a mean age: 58.4 +/- 17.5 range of 29-85 years) patients with renal failure who have used antibiotics.
Twelve patients were receiving a total of 19 antibiotics including mainly beta-lactams. The mean duration of time between start of antibiotic treatment and NCSE was 8.0 (3-21) days. In all of the patients, neurological symptoms were slowly progressive and consisted of depression of consciousness and/or disorientation. Diazepam administration resulted in marked reduction or completely disappears of epileptic activity. Four of 12 patients (33%) died, but none of were associated with NCSE but primarily associated with infection developed secondary to the preexisting disease and with congestive heart failure which patients already had.
Antibiotics, especially beta-lactams could be neurotoxic and may cause of NCSE. NCSE should be considered in patients with unexplained loss of consciousness; EEG must be a part of investigations in patients with uraemia receiving antibiotics.
非惊厥性癫痫持续状态（NCSE）：一种可能与不同程度意识改变相关且无明显运动体征的病症。有已发表的报告称其可能与肾衰竭使用抗生素的患者有关。
这是一项对12例使用过抗生素的肾衰竭NCSE患者（2例男性，10例女性，平均年龄：58.4±17.5岁，年龄范围29 - 85岁）的回顾性分析。
12例患者共使用了19种抗生素，主要为β - 内酰胺类。抗生素治疗开始至发生NCSE的平均时间为8.0（3 - 21）天。所有患者的神经症状呈缓慢进展，包括意识减退和/或定向障碍。给予地西泮后癫痫活动明显减少或完全消失。12例患者中有4例（33%）死亡，但均与NCSE无关，主要与原有疾病继发的感染以及患者已有的充血性心力衰竭有关。
抗生素，尤其是β - 内酰胺类可能具有神经毒性，可能导致NCSE。对于不明原因意识丧失的患者应考虑NCSE；脑电图检查必须作为接受抗生素治疗的尿毒症患者检查的一部分。
