Varied responses to benzodiazepine treatment in cephalosporin-related generalized periodic discharges.
Although benzodiazepines (BZDs) are used as the first-line treatment for status epilepticus, previous studies have shown inconsistent responses to BZDs in patients with cephalosporin-related non-convulsive status epilepticus. In this study, we investigated nine patients with cephalosporin-related impaired consciousness and their EEGs all showed generalized periodic discharges (GPDs). One of the patients received repetitive BZD injections without discontinuing cephalosporins, and neither his clinical symptoms nor GPDs on EEG responded to BZDs. Seven of the patients received BZDs after discontinuation of cephalosporins, but only two of them responded immediately to BZD administration. One of the patients did not receive BZDs or antiepileptic drugs, and this patient spontaneously recovered consciousness in one day after cephalosporins were discontinued. The changes in consciousness were reversible in all of the nine patients after cephalosporins were withdrawn. The administration of intravenous BZDs in cases with impairment of consciousness and GPDs secondary to cephalosporins may help in only a small number of patients. Cephalosporin withdrawal is ultimately mandatory in these patients.
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital,, Institute of Brain Science, National Yang-Ming University,, Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Hung-Yu
HY
Liu
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital,, Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Chien-Chen
CC
Chou
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital,, Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Der-Jen
DJ
Yen
Department of Neurology, Neurological Institute, Taipei Veterans General Hospital,, Department of Neurology, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
Hsiang-Yu
HY
Yu
D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D001569:Benzodiazepines / Q000008:administration & dosage / Q000494:pharmacology*; D002511:Cephalosporins / Q000009:adverse effects*; D003244:Consciousness Disorders / Q000139:chemically induced*; D004829:Epilepsy, Generalized / Q000139:chemically induced* / Q000188:drug therapy*; D006801:Humans
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D001569:Benzodiazepines
benzodiazepine; cephalosporin; encephalopathy; generalized periodic discharge; non-convulsive status epilepticus