Cefepime-Associated SIRPIDs in a Patient With Normal Renal Function.
Cefepime has been associated with encephalopathy and with nonconvulsive seizure activity, primarily in patients with renal impairment. Here, we report a case of cefepime-associated encephalopathy in a patient with normal renal function with stimulus-induced rhythmic activity seen on electroencephalogram, which resolved on discontinuation of cefepime. We bring this to the attention of the neurohospitalist community, as cefepime is widely used in the hospital setting, and cefepime-related neurotoxicity may go overlooked, especially in patients with normal renal function. Neurologists must recognize drug-related patterns, as the treatment is removing a medication rather than adding an antiepileptic medication.
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Emily
E
Johnson
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Anesthesiology and Critical Care Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Yousef
Y
Hannawi
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Nirma Carballido
NC
Martinez
Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Eva K
EK
Ritzl
electroencephalography; electrophysiology; infectious disease medicine; neurohospitalist; neurotoxicity
Arch Neurol. 2011 Oct;68(10):1303-7
21987544
Pediatr Nephrol. 2004 Apr;19(4):445-7
14986079
Neurophysiol Clin. 2000 Dec;30(6):383-6
11191931
Ann Pharmacother. 2004 Apr;38(4):606-8
14982986
Neurology. 2000 Jun 13;54(11):2153-5
10851381
Arq Neuropsiquiatr. 2014 Aug;72(8):643-4
25098483
J Nephrol. 2008 Jul-Aug;21(4):526-34
18651542
Neurocrit Care. 2009;10(3):347-51
19034700
Epilepsia. 2004 Feb;45(2):109-23
14738418
J Clin Neurophysiol. 2011 Oct;28(5):493-6
21946363
Epilepsy Behav. 2006 Feb;8(1):312-4
16278098
J Clin Neurophysiol. 2014 Jun;31(3):e6-10
24887613
Epilepsia. 2005 Sep;46(9):1550-2
16146453
Neurology. 2000 Dec 12;55(11):1756-7
11113245