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Ifosfamide encephalopathy and nonconvulsive status epilepticus
Alberto Primavera1, Daniela Audenino, Leonardo Cocito
1Department of Neurological Sciences and Vision, University of Genova, Italy.
Summary
Ifosfamide (IFX) chemotherapy can cause IFX encephalopathy, characterized by confusion and mutism. Nonconvulsive status epilepticus (NCSE) is a likely cause, improving with diazepam treatment.
Area of Science:
- Neuroscience
- Oncology
- Pharmacology
Background:
- Ifosfamide (IFX) is an alkylating agent used in chemotherapy for various cancers.
- IFX can cause encephalopathy, presenting with neurological symptoms like confusion and mutism.
Observation:
- Two patients with non-Hodgkin's lymphoma developed mutism and confusion post-IFX infusion.
- Electroencephalogram (EEG) revealed nonconvulsive status epilepticus (NCSE) as the cause of confusion.
Findings:
- EEG abnormalities are documented in IFX treatment, with NCSE diagnosed in some cases.
- Diazepam administration led to apparent improvement in the patients' confusional state.
Implications:
- NCSE may be an underdiagnosed cause of IFX-induced encephalopathy.
- Early EEG monitoring and prompt treatment with benzodiazepines could improve patient outcomes.