title: Seizure as a neurologic complication after liver transplant.
abstract: OBJECTIVE
  Seizure is a common complication after liver transplant and has been reported to occur in up to 42% of patients in different case series. Multiple factors can trigger seizures, including immunosuppressive toxicity, sepsis, metabolic imbalance, and structural brain lesions. The aim of this retrospective study was to evaluate seizure types and associated factors in adult liver transplant patients.
  
  
  METHODS
  We retrospectively evaluated the medical records of 142 adult patients who received a liver transplant between 2005 and 2013. We recorded demographic data, immunosuppressive treatment, seizure type, cause, recurrence, and treatment.
  
  
  RESULTS
  Of the 146 patients, 23 (15.7%) had a seizure after the liver transplant. This group included 10 females and 13 males, with ages ranging between 18 and 63 (39.9 ± 14.8 y). Generalized tonic-clonic seizures were the most common, occurring in 20 patients (87%). We observed complex partial seizure and status epilepticus in 1 and 2 patients. Immunosuppressive drug-related seizure occurred in 8 patients (34.8%) with normal drug blood levels, and all but 1 of these patients experienced seizure within the first week after transplant. Multiple factors (26.1%), metabolic imbalance (17.4%), structural lesion (13%), and sepsis (8.7%) were the other factors identified as underlying conditions.
  
  
  CONCLUSIONS
  In conclusion, seizure occurred in a significant proportion of patients who underwent liver transplant. Immunosuppressive drugs were the most common factor associated with seizure occurrence and drug cessation prevented seizure recurrence.
authors.affiliation: From the Department of Neurology, Baskent University, School of Medicine, Ankara, Turkey.
authors.forename: Eda
authors.initials: E
authors.lastname: Derle
authors.forename: Seda
authors.initials: S
authors.lastname: Kibaroğlu
authors.forename: Ruhsen
authors.initials: R
authors.lastname: Öcal
authors.forename: Mahir
authors.initials: M
authors.lastname: Kırnap
authors.forename: Münire
authors.initials: M
authors.lastname: Kılınç
authors.forename: Sibel
authors.initials: S
authors.lastname: Benli
authors.forename: Mehmet
authors.initials: M
authors.lastname: Haberal
mesh_terms: D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D012640:Seizures / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D007166:Immunosuppressive Agents