The Analysis Of Cases Suffering From Drug-Induced Encephalopathy With Seizures And Literature Review

Background:The definition of drug-induced encephalopathy remains controversial.It is commonly induced by several drugs and characterized by brain dysfunction as seizure,disturbances in consciousness and cognitive disorder.Drug-induced encephalopathy can occur to patients of every age,most commonly in those who have allergic history or impaired liver or kidney function.The onset of the disease is rapid while the prognosis is usually good.However,it might remain brain parenchyma damage if treatment is not in time.Objective:Through the literature of drug-induced encephalopathy and analysis of general drugs,possible pathophysiological mechanisms,diagnostic examinations,and general treatment,we could get some conclusions which may benefit the diagnostics and prevention of drug-induced encephalopathy in the future.Cases material:Clinical data of 4 patients with seizures admitted to Department of Neurology of our hospital from 2018 to 2020 were collected.The first 78-year-old one complained“sudden unconsciousness accompanied by a convulsive attack for 4 h”.The symptom was considered to be induced by ceftazidime.The second one was a 76-year-old patient suffering from the symptoms induced by Madopar.She complained“paroxysmal convulsions 5 h”.The third patient was a 69-year-old woman who had suffered from left limb dysfunction for 2 days with convulsion for 1 day which was highly considered to be induced by lidocaine.The 4th patient was a 75-year-old man who suffered from paroxysmal convulsions for 1 mouth,which was considered to be caused by sodium valproate.The prognosis of the four patients were all good.Result:After discontinuation of the drugs and symptomatic treatment,three of the patients were relieved without remaining relevant neurological symptoms,and no obvious abnormalities were found in neurological examination.In patients with valproate encephalopathy,symptoms were partially relieved,consciousness was improved,and electroencephalography did not return to normal after the reduction of sodium valproate.Conclusion:1.Drug-induced encephalopathy caused by ceftazidime,Madopar,lidocaine or sodium valproate with seizures as clinical symptoms has no obvious causes except suspected drugs.The onset is rapid,the prognosis is good.2.The convulsions of drug-induced encephalopathy caused by ceftazidime,Madopar,lidocaine can be completely relieved after drug withdrawal,while the symptoms in valproate encephalopathy could be partially relieved by gradual reduction of sodium valproate.The EEG of patients with encephalopathy can be normal or show abnormal changes,and the EEG of some patients can return to normal after symptom relief.3.All the 4 patients listed in this paper had a history of drug allergy or abnormal renal function,which should be noted for the patients receiving ceftazidime,Madopar,lidocaine or sodium valproate.