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[Seizure and tremor occurring in acute leukemia patients treated with imipenem/cilastatin]
Abstract:
We report here four patients with acute leukemia, who developed seizure or tremor following treatment with imipenem, a new broad-spectrum antibiotic. All four patients had no renal dysfunction and recovered after discontinuation of the drug. Two patients who developed seizure had a past history of cerebral hemorrhage with symptoms of meningitis in one and the other had received frequent intrathecal injections of methotrexate. Seizure also occurred in another patient who was given multiple intrathecal injections of methotrexate. The remaining old patient developed tremor after the first administration of imipenem which did not progress to convulsion. Cerebral hemorrhage or meningitis is known to predispose patients for convulsion following imipenem treatment. In addition, the present study suggests that central nervous system damage related with intrathecal injections of methotrexate may be a predisposing factor. Thus, imipenem should be given with caution to acute leukemia patients who often have risk factors for developing imipenem-related complications.
Insights
Four acute leukemia patients experienced seizures or tremors after imipenem treatment. Neurological complications like meningitis or methotrexate use may increase seizure risk with this antibiotic.
Area of Science:
- Neurology
- Pharmacology
- Oncology
Background:
- Imipenem is a broad-spectrum antibiotic used in treating various infections.
- Acute leukemia patients often have complex medical histories and are susceptible to adverse drug reactions.
Observation:
- Four patients with acute leukemia developed neurological adverse events, specifically seizure or tremor, after receiving imipenem.
- These patients had no renal dysfunction and their symptoms resolved upon imipenem discontinuation.
Findings:
- Two patients with seizures had a history of cerebral hemorrhage with meningitis or received intrathecal methotrexate.
- Another patient receiving intrathecal methotrexate also experienced seizures.
- An elderly patient developed tremor after the first imipenem dose.
Implications:
- Previous central nervous system damage from conditions like meningitis or intrathecal methotrexate may predispose patients to imipenem-induced seizures.
- Imipenem should be administered cautiously in acute leukemia patients, considering their potential risk factors for neurological complications.