Clarithromycin-induced Seizures and Status Epilepticus
Raghavendra Seetharam1, Rajesh B Iyer1, Javeria Nooraine1
1Department of Neurology, Vikram Hospital, Bengaluru, Karnataka, India.
Summary
Clarithromycin, a common antibiotic, can rarely cause seizures and status epilepticus (SE). This case highlights the importance of considering clarithromycin as a potential cause in elderly patients presenting with these neurological events.
Area of Science:
- Neurology
- Pharmacology
- Internal Medicine
Background:
- Neuropsychiatric adverse effects of clarithromycin are known.
- Seizures and status epilepticus (SE) are rare but serious potential side effects.
Purpose of the Study:
- To report a case of clarithromycin-induced seizures and status epilepticus in an elderly patient.
- To emphasize the need for prompt recognition and management of this adverse drug reaction.
Main Methods:
- A case report of an elderly patient who developed generalized tonic-clonic seizures (GTCS) and nonconvulsive status epilepticus (NCSE).
- Exclusion of other potential causes of seizures through MRI, CSF analysis, and laboratory studies.
- Cessation of clarithromycin and initiation of parenteral antiepileptic drugs.
Main Results:
- The patient developed GTCS followed by NCSE two days after initiating clarithromycin.
- Causal link established after excluding other etiologies.
- Seizures were controlled after drug withdrawal and treatment.
Conclusions:
- Clarithromycin can induce seizures and status epilepticus, particularly in the elderly.
- Physicians should be aware of this potential adverse effect for timely diagnosis and intervention.
- Differential diagnosis in the elderly presenting with seizures should include medication side effects.
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