Ceftriaxone-Induced Non-Convulsive Status Epilepticus in an Elderly Patient with Renal Insufficiency

Huang Hsuan ； Chen Yun-Chung ； Lin Yi-Hsin

《International Journal of Gerontology》 13卷1期 (2019/03) Pp. 87-89

https://doi.org/10.1016/j.ijge.2018.03.016

摘要

Ceftriaxone, third-generation cephalosporin, is widely used in patients for the treatment of serious gram-negative infection without a dose adjustment for renal insufficiency. Ceftriaxone-induced neurotoxicity, particularly non-convulsive status epilepticus (NCSE), has rarely been reported. We present a case of ceftriaxone-induced non-convulsive status epilepticus in treatment of complicated urinary tract infection and acute on chronic kidney disease (CKD) for a 71-year-old woman. The prognosis of NCSE is poor in elderly patients due to a delay in diagnosis and treatment may be associated with increased mortality or neuronal loss, as well as dysfunction of cognitive and behavioral abilities. Emergent and continuous electroencephalogram monitoring can assist physicians in both early recognition and accurate management of NCSE. Immediate withdrawal of cephalosporin is necessary. Antiepileptic drugs may be helpful but data of prognosis are still lacking. Physicians should be aware of the potential neurotoxic complication in those with high risks (elderly, CKD, or prior central nervous system conditions).

關鍵字

ceftriaxone ； cephalosporin ； non-convulsive status epilepticus ； neurotoxicity