Cefepime-Induced Nonconvulsive Status Epileticus Presenting as Coma in a Patient with ESRD on Hemodialysis

Korean Journal of Nephrology 2011;30(5):537-541.

Cho-I Lee, M.D.1, Mi-Jin Hong, M.D.1, Sung-Chul Hong, M.D.1, Jung-Hee Park, M.D.1, Eugene Park, M.D.1, Jang-Soo Han, M.D.1, Young-Jin Kim, M.D.2, Jong-Ho Lee, M.D.1, Jung-Hwan Park, M.D.1, Jong-Oh Song, M.D.1 and Young-Il Jo, M.D.1

Division of Nephrology, Department of Internal Medicine1 and Department of Neurology²
Konkuk University School of Medicine, Seoul, Korea

증례 : 혈액투석 환자에서 혼수로 발현된 cefepime에 의한 비경련성 간질 중첩증

이초이1, 홍미진1, 홍성철1, 박중희1, 박유진1, 한장수1, 김영진2, 이종호1, 박정환1, 송종오1, 조영일1

건국대학교 의학전문대학원 내과학교실1 , 신경과학교실2

Abstract

Cefepime-induced nonconvulsive status epilepticus (NCSE) in end-stage renal disease (ESRD) patients receiving hemodialysis has only rarely been reported. Here we report a case of cefepime-induced NCSE presenting as coma in a patient with ESRD on hemodialysis. A 73-year-old man, who had been receiving maintenance hemodialysis, developed aphasia and coma during cefepime therapy for epidural abscess. Emergent eletroencephalography (EEG) revealed evidence of NCSE. The abnormal EEG findings were resolved and comatose mentality was completely recovered after cessation of cefepime and administration of anticonvulsive drugs. Cefepime-induced NCSE should be considered if neurological symptoms including comatose mentality develops during cefepime therapy in a patient with renal failure.

Key Words: Cefepime, Nonconvulsive status epilepticus, Hemodialysis