Park Hyeon-Mi, Noh Young, Yang Ji Won, Shin Dong Hoon, Lee Yeong-Bae
Department of Neurology, Gachon University Gil Medical Center, Incheon, Korea.
J Epilepsy Res. 2016 Dec 31;6(2):97-99. doi: 10.14581/jer.16018. eCollection 2016 Dec.
Cefepime-induced encephalopathy including nonconvulsive status epilepticus has been known to develop in the patients with renal impairment. However, we report a 74-year-old woman with normal renal function who developed stuporous mental status during cefepime administration. Electroencephalogram (EEG) revealed 2 Hz rhythmic sharp-and-waves continuously, which suggested nonconvulsive status epilepticus (NCSE). After cefepime discontinuation, clinical symptoms recovered gradually and EEG findings showed only background slowing without epileptiform discharges. Cefepime-induced NCSE could be developed even in the patients with normal renal function, when they are elderly. Therefore, clinicians should be aware of the possibility of cefepime-induced NCSE when prescribing cefepime even to the patients with normal renal function.
已知在肾功能损害患者中会发生包括非惊厥性癫痫持续状态在内的头孢吡肟诱发的脑病。然而,我们报告了一名74岁肾功能正常的女性,在使用头孢吡肟期间出现了昏迷的精神状态。脑电图(EEG)显示持续的2Hz节律性尖波和慢波,提示非惊厥性癫痫持续状态(NCSE)。停用头孢吡肟后,临床症状逐渐恢复,EEG结果仅显示背景减慢,无癫痫样放电。即使在肾功能正常的老年患者中也可能发生头孢吡肟诱发的NCSE。因此,临床医生在给肾功能正常的患者开头孢吡肟时,应意识到头孢吡肟诱发NCSE的可能性。