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| Year : 2012 | Volume
: 23
| Issue : 2 | Page : 349 |
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| Neurotoxicity due to cefepime in patients on maintenance hemodialysis |
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Nauman Siddiqi, Iftikhar Sheikh
Department of Nephrology, King Fahd Armed Forces Hospital, P. O. Box 9862, Jeddah, Saudi Arabia
Click here for correspondence address and email
| Date of Web Publication | 28-Feb-2012 |
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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 2017 May 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 | |  |
| 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. 
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| 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.
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| 3. | Wong KM, Chan WK, Chan YH, Li CS. Cefepime-related neurotoxicity in a hemo-dialysis patient. Nephrol Dial Transplant 1999; 14:2265-6.
[PUBMED] [FULLTEXT] |
| 4. | Dixit S, Kurle P, Buyant-Dent L, Sheth RD. Status epilepticus associated with Cefepime. Neurology 2000;54:2153-5.
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| 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.
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| 6. | Murthy JM, Naryanan TJ. Continuous EEG monitoring in the evaluation of non-convulsive seizures and status epilepticus. Neuro India 2004;52:430-5.
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| 7. | Sheikh I, Dahbour S, Siddiqi NA. Non-convulsive Status Epilepticus: High Incidence in Dialysis Dependent Patients. Hemodial Int 2007;11:392-7.
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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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