Seetharam Raghavendra, Iyer Rajesh B, Nooraine Javeria, Ramachandran Jaychandran
Department of Neurology, Vikram Hospital, Bengaluru, Karnataka, India.
Indian J Crit Care Med. 2021 Aug;25(8):945-947. doi: 10.5005/jp-journals-10071-23900.
Clarithromycin is a commonly used antibiotic. Neuropsychiatric adverse effects are recognized, but the occurrence of seizures and status epilepticus (SE) has been rarely reported. We report the case of an elderly patient who developed generalized tonic-clonic seizures (GTCS) followed by nonconvulsive status epilepticus (NCSE), 2 days after starting clarithromycin. Other causes of seizures were excluded by magnetic resonance imaging (MRI) of the brain, CSF analysis, and routine laboratory studies, thus establishing the causal role of clarithromycin. Clarithromycin was stopped and parenteral antiepileptic drugs started, which controlled the status. In the elderly, symptoms like delirium, drowsiness, confusion, or seizures can occur due to an underlying systemic disease, brain pathology, or adverse effects of medications, all of which must be correctly differentiated. This case illustrates the occurrence of seizures and SE due to clarithromycin. Awareness about this possibility will help physicians recognize and treat such situations promptly. Seetharam R, Iyer RB, Nooraine J, Ramachandran J. Clarithromycin-induced Seizures and Status Epilepticus. Indian J Crit Care Med 2021;25(8):945-947.
克拉霉素是一种常用抗生素。其神经精神方面的不良反应已为人所知，但癫痫发作和癫痫持续状态（SE）的发生却鲜有报道。我们报告一例老年患者，在开始使用克拉霉素2天后出现全身强直阵挛性发作（GTCS），随后发展为非惊厥性癫痫持续状态（NCSE）。通过脑部磁共振成像（MRI）、脑脊液分析和常规实验室检查排除了其他癫痫病因，从而确定了克拉霉素的因果关系。停用克拉霉素并开始使用肠外抗癫痫药物后，病情得到控制。在老年人中，谵妄、嗜睡、意识模糊或癫痫发作等症状可能由潜在的全身性疾病、脑部病变或药物不良反应引起，所有这些都必须正确区分。本病例说明了克拉霉素可导致癫痫发作和SE。认识到这种可能性将有助于医生及时识别和处理此类情况。Seetharam R, Iyer RB, Nooraine J, Ramachandran J. 克拉霉素诱发的癫痫发作和癫痫持续状态。《印度危重症医学杂志》2021年；25(8):945 - 947。
