Fat Embolism and Nonconvulsive Status Epilepticus.
Yanetsy Olivera Arencibia1, Mai Vo1, Jennifer Kinaga1
1Department of Medicine, Orlando Regional Healthcare, Orlando, Florida, USA.
Case Reports in Neurological Medicine
|January 24, 2019
Summary
Fat embolism syndrome (FES) can cause altered mental status. Early recognition and supportive care, including antiepileptic drugs, are crucial for favorable outcomes in nonconvulsive status epilepticus.
Area of Science:
- Neurology
- Trauma Surgery
Background:
- Fat embolism syndrome (FES) is a potential complication of orthopedic trauma.
- Altered mental status is a common neurological manifestation of FES.
- Nonconvulsive status epilepticus (NCSE) has been reported in FES, presenting as altered consciousness without seizures.
Observation:
- A 56-year-old male developed altered mental status 24 hours after femur fracture fixation.
- Neuromonitoring confirmed nonconvulsive status epilepticus.
- Brain MRI revealed bilateral cerebral infarcts characteristic of FES.
Findings:
- The patient had a right-to-left intracardiac shunt, a potential risk factor for FES.
- NCSE in this FES case responded to antiepileptic drugs, sedation, and supportive care.
- The patient showed significant neurological improvement and was discharged for rehabilitation.
Implications:
- Fat embolisms can cause diverse neurological symptoms, including NCSE.
- Early diagnosis and prompt management of NCSE in FES are associated with better patient outcomes.
- A high index of suspicion for FES-related neurological complications is vital for timely intervention and improved survival.
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