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Saudi Journal of Kidney Diseases and Transplantation
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Table of Contents   
LETTER TO THE EDITOR  
Year : 2012  |  Volume : 23  |  Issue : 2  |  Page : 349
Neurotoxicity due to cefepime in patients on maintenance hemodialysis


Department of Nephrology, King Fahd Armed Forces Hospital, P. O. Box 9862, Jeddah, Saudi Arabia

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Date of Web Publication28-Feb-2012
 

How to cite this article:
Siddiqi N, Sheikh I. Neurotoxicity due to cefepime in patients on maintenance hemodialysis. Saudi J Kidney Dis Transpl 2012;23:349

How to cite this URL:
Siddiqi N, Sheikh I. Neurotoxicity due to cefepime in patients on maintenance hemodialysis. Saudi J Kidney Dis Transpl [serial online] 2012 [cited 2014 Apr 24];23:349. Available from: http://www.sjkdt.org/text.asp?2012/23/2/349/93173
To the Editor ,

We read with interest the cases described by Yadla et al in their article entitled "Neuro-toxicity due to cefepime in patients on main­tenance hemodialysis." [1] There have been mul­tiple reports of neurological symptoms secon­dary to cephalosporins in general and to cefe-pime in particular. [2],[3],[4] Interestingly, both the patients reported showed signs of myoclonus and aphasia, which may be signs of non-con­vulsive status epilepticus. [5] The one study that could have easily diagnosed this entity (EEG) was not performed in the two cases. [6] Cefepime has been reported to cause non-convulsive status epilepticus. [2],[3],[4],[7] The doses given were also not clearly mentioned as higher than usal doses have been associated with more neuro­logical effects. [7] There is a high possibility that the two patients may have had non-convulsive status epilepticus which is easily diagnosed with a routine EEG and easily terminated with benzodiazapines along with hemodialysis.

 
   References Top

1.Yadla M, Krishna Kishore C, Sriramnaveen P, et al. Neurotoxicity due to cefepime in patients on maintenance hemodialysis. Saudi J Kidney Dis Transpl 2011;22(5):1026-7.  Back to cited text no. 1
    
2.Martinez-Rodriguez JE, Barriga FJ, Santamaria J, et al. Non-convulsive status epilepticus asso­ciated with cephalosporins in patients with renal failure. Am J Med 2001;111:115-9.  Back to cited text no. 2
    
3.Wong KM, Chan WK, Chan YH, Li CS. Cefepime-related neurotoxicity in a hemo-dialysis patient. Nephrol Dial Transplant 1999; 14:2265-6.  Back to cited text no. 3
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4.Dixit S, Kurle P, Buyant-Dent L, Sheth RD. Status epilepticus associated with Cefepime. Neurology 2000;54:2153-5.  Back to cited text no. 4
    
5.Hussain AM, Horn GJ, Jacobson MP. Non-convulsive status epilepticus: Usefulness of clinical features in selecting patients for urgent EEG. J Neurol Neurosurg Psychiatry 2003;74: 189-91.  Back to cited text no. 5
    
6.Murthy JM, Naryanan TJ. Continuous EEG monitoring in the evaluation of non-convulsive seizures and status epilepticus. Neuro India 2004;52:430-5.  Back to cited text no. 6
    
7.Sheikh I, Dahbour S, Siddiqi NA. Non-con­vulsive Status Epilepticus: High Incidence in Dialysis Dependent Patients. Hemodial Int 2007;11:392-7.  Back to cited text no. 7
    

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Correspondence Address:
Nauman Siddiqi
Department of Nephrology, King Fahd Armed Forces Hospital, P. O. Box 9862, Jeddah
Saudi Arabia
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PMID: 22382234

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