Bhardwaj A, Badesha P S
Veterans Affairs Medical Center, Dayton, OH 45428, USA.
Ann Pharmacother. 1995 Dec;29(12):1237-9. doi: 10.1177/106002809502901210.
To describe a patient with ifosfamide-induced nonconvulsive status epilepticus.
A 71-year-old woman with a history of malignant mixed mesodermal tumor involving the uterus, cervix, and vagina was admitted because of local recurrence. After receiving 3 doses of ifosfamide/mesna, she was found to be unresponsive. Physical examination and laboratory data revealed no significant changes. An electroencephalogram was consistent with the diagnosis of nonconvulsive status epilepticus. The patient's mental status returned to baseline after treatment with intravenous phenytoin and discontinuation of ifosfamide therapy.
Central nervous system (CNS) toxicity has been described with ifosfamide, with most cases reported in the pediatric population. Among CNS toxicities, generalized tonic-clonic seizures have been reported in both children and adults. This represents the first report of nonconvulsive status epilepticus induced by ifosfamide.
There was a temporal relationship between the onset of nonconvulsive status epilepticus and initiation of ifosfamide infusion. No other identifiable factor contributed to the unresponsiveness.
描述一例异环磷酰胺诱发的非惊厥性癫痫持续状态患者。
一名71岁女性，有子宫、宫颈和阴道恶性混合性中胚叶肿瘤病史，因局部复发入院。在接受3剂异环磷酰胺/美司钠后，发现她无反应。体格检查和实验室检查数据无明显变化。脑电图检查结果符合非惊厥性癫痫持续状态的诊断。经静脉注射苯妥英钠治疗并停用异环磷酰胺治疗后，患者的精神状态恢复至基线水平。
异环磷酰胺已被证实可导致中枢神经系统（CNS）毒性，大多数病例报告见于儿科人群。在中枢神经系统毒性中，儿童和成人都曾报告过全身性强直阵挛发作。这是异环磷酰胺诱发非惊厥性癫痫持续状态的首例报告。
非惊厥性癫痫持续状态的发作与异环磷酰胺输注开始之间存在时间关系。没有其他可识别的因素导致无反应状态。
