title: Management of star fruit-induced neurotoxicity and seizures in a patient with chronic renal failure.
abstract: An 84-year-old Asian woman with hypertension and chronic renal failure was evaluated for incoherent speech, followed by intermittent interruptions of consciousness, and then status epilepticus after ingesting one star fruit (Averrhoa carambola) each day for 3 days. Conventional first-line anticonvulsants and hemodialysis were administered without significant control of the patient's seizures. Treatment was started with propofol, an intravenous agent that induces anesthesia with rapid onset and elimination from the central nervous system; this resulted in complete control of the seizures. Propofol may be an effective alternative when dialysis and conventional first-line anticonvulsants are unsuccessful in treating the symptoms of neurotoxicity.
authors.affiliation: Department of Pharmacy, Chang Gung Memorial Hospital at Kaohsiung, Kaohsiung County, Taiwan.
authors.forename: Yu-Chin Lily
authors.initials: YC
authors.lastname: Wang
authors.forename: Ber-Ming
authors.initials: BM
authors.lastname: Liu
authors.forename: Robert B
authors.initials: RB
authors.lastname: Supernaw
authors.forename: Yu-Hong
authors.initials: YH
authors.lastname: Lu
authors.forename: Ping-Yu
authors.initials: PY
authors.lastname: Lee
mesh_terms: D000369:Aged, 80 and over; D018686:Anesthetics, Intravenous / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D003128:Coma / Q000139:chemically induced / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D005638:Fruit / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D020258:Neurotoxicity Syndromes / Q000209:etiology / Q000628:therapy*; D015742:Propofol / Q000627:therapeutic use; D006435:Renal Dialysis; D012640:Seizures / Q000209:etiology / Q000628:therapy*
chemical_list: D018686:Anesthetics, Intravenous; D000927:Anticonvulsants; D015742:Propofol