Encefalopatia induzida por cefepime: achados clínicos e eletroencefalográficos em sete pacientes

Abstract

RESUMO -Cefepime, uma cefalosporina de quarta geração, com amplo espectro de ação, é um antibiótico largamente utilizado no tratamento de infecções graves em ambientes hospitalares. O registro de segurança deste fármaco é considerado favorável. Vários casos de encefalopatia grave, associada ao uso de cefepime, reversível, foram descritos recentemente. No presente artigo, descrevemos sete casos de encefalopatia induzida por cefepime, com achados eletroencefalográficos (EEG) característicos, que apresentaram reversão do quadro com a suspensão da droga. As relações do padrão EEG encontrado nestes pacientes com estado epiléptico não-convulsivo são consideradas, bem como a possibilidade de enquadrar os pacientes estudados na entidade "encefalopatia epileptiforme". PALAVRAS-CHAVE: encefalopatia epileptiforme, padrão EEG periódico, estado epiléptico não-convulsivo, neurotoxicidade, cefepime. Cefepime-induced encephalopathy : clinical and electroencephalographic features in seven patientsABSTRACT -Cefepime, a fourth-generation cephalosporin, with large antibacterial spectrum, is a commonly used antibiotic for the treatment of serious hospitalar infections. Its security report is considered favourable. Recently, many cases of a severe and reversible cefepime-induced encephalopathy were described. In this p a p e r, we report seven patients with reversible cefepime-induced encephalopathy, with a peculiar EEG pattern, characterized by semiperiodic diffuse triphasic waves. We discuss the EEG abnormalities found and their association with nonconvulsive status epilepticus.

Drug Induced Encephalopathy in Patients with Chronic Kidney Disease: A Case Series

“…Cephalosporin encephalopathy is associate with characteristic EEG findings which include diffuse slow-wave delta activity, semi periodic tri phasic sharp wave activity, or frank periodic discharges, paroxysmal myoclonic or convulsive bursts may also be observed. [13][14][15] Underlying mechanism of their toxicity is to inhibition of GABA A receptor. 16 Withdrawal of the drug is associated with reversal of encephalopathy.…”

Imipenem-associated encephalopathy: alert to physicians

“…Broadly used antibiotics such cefepime are soundly related to various abnormal mental status disorders 5 . The clinical picture and EEG findings from cefepime encephalopathy can perfectly be superimposed to our case.…”

Cefepime-induced Encephalopathy with Triphasic Waves in Three Asian Patients

“…2 Previous case reports have documented triphasic waves on electroencephalography (EEG) in cephalosporin-induced encephalopathy. [1][2][3][4] Cefalosporin-induced encephalopathy with triphasic waves has not been previously reported among Asians. We report 3 Asian patients with toxic encephalopathy and documented triphasic waves on EEG while on treatment with cefepime.…”