title: Nonconvulsive status epilepticus due to ifosfamide.
abstract: OBJECTIVE
  To report 2 cases of nonconvulsive status epilepticus (NCSE) following infusion of ifosfamide.
  
  
  METHODS
  Two patients who received ifosfamide-containing chemotherapy developed NCSE. One woman received ifosfamide 1000 mg/m2 (1 h infusion on days 1-5); confusion, lethargy, and speech deterioration developed on day 3. The second patient developed similar symptoms on day 3 of treatment with 2500 mg/m2. Both patients responded to intravenous administration of diazepam 10 mg and were given levetiracetam as maintenance therapy.
  
  
  CONCLUSIONS
  The severity and presentation of central nervous system toxicity due to ifosfamide varies greatly and involves a spectrum ranging from subclinical electroencephalogram changes to coma. NCSE, an epileptic disorder in which typical convulsive activity is absent, has previously been reported in only 4 patients receiving ifosfamide. Levetiracetam may be used for maintenance antiepileptic therapy after diazepam administration.
  
  
  CONCLUSIONS
  Among the many presentations of ifosfamide neurotoxicity, clinicians should consider NCSE as a possible explanation for changes in consciousness in a patient receiving this agent. An objective causality assessment by use of the Naranjo probability scale revealed that NCSE due to ifosfamide was probable.
authors.affiliation: Department of Medical Oncology, Hacettepe University Institute of Oncology, Sihhiye, Ankara, Turkey. skilickap@yahoo.com
authors.forename: Saadettin
authors.initials: S
authors.lastname: Kilickap
authors.forename: Mustafa
authors.initials: M
authors.lastname: Cakar
authors.forename: Ibrahim K
authors.initials: IK
authors.lastname: Onal
authors.forename: Abdurrahman
authors.initials: A
authors.lastname: Tufan
authors.forename: Hadim
authors.initials: H
authors.lastname: Akoglu
authors.forename: Sercan
authors.initials: S
authors.lastname: Aksoy
authors.forename: Mustafa
authors.initials: M
authors.lastname: Erman
authors.forename: Gulten
authors.initials: G
authors.lastname: Tekuzman
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D018906:Antineoplastic Agents, Alkylating / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D003975:Diazepam / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007069:Ifosfamide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D000077287:Levetiracetam; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use; D013226:Status Epilepticus / Q000139:chemically induced* / Q000188:drug therapy
chemical_list: D000927:Anticonvulsants; D018906:Antineoplastic Agents, Alkylating; D000077287:Levetiracetam; D003975:Diazepam; D007069:Ifosfamide; D010889:Piracetam