title: Non-convulsive status epilepticus following antibiotic therapy as a cause of unexplained loss of consciousness in patients with renal failure.
abstract: BACKGROUND
  Non-convulsive status epilepticus (NCSE): a condition that may be associated with different levels of altered consciousness without any apparent motor signs. There are published reports that it may be associated with antibiotic use patients with renal failure.
  
  
  METHODS
  This is a retrospective analysis of our 12 NCSE (2 men, 10 women, a mean age: 58.4 +/- 17.5 range of 29-85 years) patients with renal failure who have used antibiotics.
  
  
  RESULTS
  Twelve patients were receiving a total of 19 antibiotics including mainly beta-lactams. The mean duration of time between start of antibiotic treatment and NCSE was 8.0 (3-21) days. In all of the patients, neurological symptoms were slowly progressive and consisted of depression of consciousness and/or disorientation. Diazepam administration resulted in marked reduction or completely disappears of epileptic activity. Four of 12 patients (33%) died, but none of were associated with NCSE but primarily associated with infection developed secondary to the preexisting disease and with congestive heart failure which patients already had.
  
  
  CONCLUSIONS
  Antibiotics, especially beta-lactams could be neurotoxic and may cause of NCSE. NCSE should be considered in patients with unexplained loss of consciousness; EEG must be a part of investigations in patients with uraemia receiving antibiotics.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, Haseki Training and Research Hospital, Istanbul, Turkey. savasozturkdr@yahoo.com.|Haseki Egitim ve Arsatirma Hastanesi, Ic Hastaliklari, 5. dahiliye servisi, Haseki, Fatih, Istanbul, Turkey. savasozturkdr@yahoo.com.
authors.forename: Savas
authors.initials: S
authors.lastname: Ozturk
authors.affiliation: Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Gonenc
authors.initials: G
authors.lastname: Kocabay
authors.affiliation: Istanbul Faculty of Medicine, Department of Neurology, Istanbul University, Istanbul, Turkey.
authors.forename: Baris
authors.initials: B
authors.lastname: Topcular
authors.affiliation: Istanbul Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Halil
authors.initials: H
authors.lastname: Yazici
authors.affiliation: Istanbul Faculty of Medicine, Department of Clinical Bacteriology and Infectious Disease, Istanbul University, Istanbul, Turkey.
authors.forename: Arif Atahan
authors.initials: AA
authors.lastname: Cagatay
authors.affiliation: Istanbul Faculty of Medicine, Division of Geriatrics, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Gulistan
authors.initials: G
authors.lastname: Bahat
authors.affiliation: Istanbul Faculty of Medicine, Department of Neurology, Istanbul University, Istanbul, Turkey.
authors.forename: Betul
authors.initials: B
authors.lastname: Baykan
authors.affiliation: Istanbul Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Aydin
authors.initials: A
authors.lastname: Turkmen
authors.affiliation: Istanbul Faculty of Medicine, Division of Nephrology, Department of Internal Medicine, Istanbul University, Istanbul, Turkey.
authors.forename: Alaattin
authors.initials: A
authors.lastname: Yildiz
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D051437:Renal Insufficiency / Q000150:complications* / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D013226:Status Epilepticus / Q000139:chemically induced* / Q000150:complications* / Q000453:epidemiology; D014474:Unconsciousness / Q000453:epidemiology / Q000209:etiology*; D014511:Uremia / Q000150:complications / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents