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Seizures in Organ Transplant Recipients

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Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

Seizures are a nonspecific neurological manifestation of cerebral dysfunction and not indicative of any particular disease processes or pathology. As such, the evaluation and treatment of seizures in transplant patients generally follow the same clinical approach as for other patients. A seizure in a transplant patient is commonly unanticipated and entirely unexplained. The effects can be substantial with aspiration, loss of vascular catheters, and tissue trauma. Patients undergoing organ transplantation are at risk of seizures for multiple reasons, and while much of the neurological and transplantation literature reports on the incidence of seizures according to the particular organ transplanted, there are many similarities (e.g., Immunosuppression drugs) and we will try to concentrate on organ transplantation as a whole.

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References

  1. Wszolek Z, Steg RE, Wijdicks EF (1999) Seizures. In: Wijdicks EF (ed) Neurologic complications in organ transplant recipients. Butterworth and Heinemann, Boston, pp 107–125

    Google Scholar 

  2. Wszolek ZK, Steg RE (1997) Seizures after orthotopic liver transplantation. Seizure 6:31–39

    Article  PubMed  CAS  Google Scholar 

  3. Martinez AJ, Estol C, AA F (1988) Neurologic complications of liver transplantation. Neurol Clin 6:327

    PubMed  CAS  Google Scholar 

  4. Adams DH, Ponsford S, Gunson B et al (1987) Neurological complications after liver transplantation. Lancet 1:949–951

    Google Scholar 

  5. Wijdicks EF, Plevak DJ, Wiesner RH, Steers JL (1996) Causes and outcome of seizures in liver transplant recipients. Neurology 47:1523–1525

    Article  PubMed  CAS  Google Scholar 

  6. Wijdicks EF, Wiesner RH, Dahlke L, Krom R (1994) FK506-induced neurotoxicity in liver transplantation. Ann Neurol 35:498

    Article  PubMed  CAS  Google Scholar 

  7. Wijdicks EF, Wiesner RH, Krom R (1995) Neurotoxicity in liver transplant recipients with cyclosporine immunosuppresion. Neurology 45:1962

    Article  PubMed  CAS  Google Scholar 

  8. Sevmis S, Karakayali H, Emiroglu R, Akkoc H, Haberal M (2007) Tacrolimus-related seizure in the early postoperative period after liver transplantation. Transplant Proc 39(4):1211–1213

    Article  PubMed  CAS  Google Scholar 

  9. Patchell RA, White CL III, Clark AW, Beschorner WE, Santos GW (1985) Neurologic complications of bone marrow transplantation. Neurology 35:300–306

    Article  PubMed  CAS  Google Scholar 

  10. Snider S, Bashir R, Bierman P (1994) Neurologic complications after high-dose chemotherapy and autologous bone marrow transplantation for Hodgkin’s disease. Neurology 44:681

    Article  PubMed  CAS  Google Scholar 

  11. Antonini G, Ceschin V, Morino S et al (1998) Early neurologic complications following allogeneic bone marrow transplant for leukemia: A prospective study. Neurology 50:1441–1445

    Article  PubMed  CAS  Google Scholar 

  12. Wszolek Z, Steg R, Armitage J Complex partial status epilepticus after bone marrow transplantation for non-Hodgkin’s lymphoma. Bone Marrow Transplant 19:637–638

    Google Scholar 

  13. Gaggero R, Haupt R, Paola Fondelli M, De Vescovi R, Marino A, Lanino E, Dallorso S, Faraci M (2006) Intractable epilepsy secondary to cyclosporine toxicity in children undergoing allogeneic hematopoietic bone marrow transplantation. J Child Neurol 21(10):861–866

    Article  PubMed  Google Scholar 

  14. Grigg MM, Costanzo-Nordin MR, Celesia GG et al (1988) The etiology of seizures after cardiac transplantation. Transplant Proc 20(Suppl 3):937

    PubMed  CAS  Google Scholar 

  15. Malheiros S, Almeida D, Massaro A et al (2002) Neurologic complications after heart transplantation. Arq Neuropsiquiatr 60:192–197

    Article  PubMed  Google Scholar 

  16. Mayer TO, Biller J, O’Donnell J, Meschia JF, Sokol DK (2002) Contrasting the neurologic complications of cardiac transplantation in adults and children. J Child Neurol 17:195–199

    Article  PubMed  Google Scholar 

  17. LM AAQ, Postlethwaite RJ, Webb NJ (1999) Seizures following renal transplantation in childhood. Pediatr Nephrol 13:275–277

    Article  Google Scholar 

  18. Kahan BD, Flechner SM, Lorber MI, Golden D, Conley S, Van Buren CT (1987) Complications of cyclosporine-prednisone immunosuppression in 402 renal allograft recipients exclusively followed at a single center for from one to five years. Transplantation 43:197–204

    Article  PubMed  CAS  Google Scholar 

  19. Gross M, Sweny P, Pearson R, Kennedy J, Fernando O, Moorhead J (1982) Rejection encephalopathy. An acute neurological syndrome complicating renal transplantation. J Neurol Sci 56:23–34

    Article  PubMed  CAS  Google Scholar 

  20. Vaughn BV, Ali, II, Olivier KN et al (1996) Seizures in lung transplant recipients. Epilepsia 37:1175–1179

    Google Scholar 

  21. Wong M, Mallory GB Jr, Goldstein J, Goyal M, Yamada KA (1999) Neurologic complications of pediatric lung transplantation. Neurology 53:1542–1549

    Article  PubMed  CAS  Google Scholar 

  22. Kiok MC (1988) Neurologic complications of pancreas transplants. Neurol Clin 6:367–376

    PubMed  CAS  Google Scholar 

  23. Alroughani R, Javidan M, Qasem A, Alotaibi N (2009) Non-convulsive status epilepticus; the rate of occurrence in a general hospital. Seizure 18(1):38–42

    Article  PubMed  CAS  Google Scholar 

  24. Wijdicks EF (1999) Neuologic Manesfestations of Immunosuppressive Agents. In: Wijdicks EF (ed) Neurologic complications in organ transplant recipients. Butterworth and Heinemann, Boston, pp 127–140

    Google Scholar 

  25. Gilmore RL (1988) Seizures and antiepileptic drug use in transplant patients. Neurol Clin 6:279–296

    PubMed  CAS  Google Scholar 

  26. Kahan BD (1989) Cyclosporin. N Eng J Med 312:1725

    Google Scholar 

  27. Rubin AM, Kang H (1987) Cerebral blindness and encephalopathy with cyclosporin A toxicity. Neurology 37:1072

    Google Scholar 

  28. Wilson SE, de Groen PC, Aksamit AJ, Wiesner RH, Garrity JA, RA K (1988) Cyclosporin A-induced reversible cortical blindness. J Clin Neuroophthalmol 8:215–220

    PubMed  CAS  Google Scholar 

  29. Truwit CL, Denaro CP, Lake JR, Demarco T (1991) MR imaging of reversible cyclosporin A-induced neurotoxicity. AJNR 12:651

    PubMed  CAS  Google Scholar 

  30. Reece DE, Frei-Lahr DA, Shepard JD et al (1991) Neurologic complications in allogenic bone marrow transplant patients receiving cyclosporin. Bone Marrow Transplant 8:393

    Google Scholar 

  31. Thompson CB, June CH, Sullivan KM, Thomas ED (1984) Association between cyclosporin neurotoxicity and hypomagnesaemia. Lancet 2:1116

    Article  PubMed  CAS  Google Scholar 

  32. de Groen PC, Aksamit AJ, Rakela J et al (1987) Central nervous system toxicity after liver transplantation. The role of cyclosporin and cholesterol. N Eng J Med 317:861

    Google Scholar 

  33. Hauben M (1996) Cyclosporine neurotoxicity. Pharmacotherapy 16:576

    PubMed  CAS  Google Scholar 

  34. Kelly PA, Burckart GJ, Venkataramanan R (1995) Tacrolimus: A new immunosuppressive agent. Am J Health Syst Pharm 53:1521

    Google Scholar 

  35. Shutter LA, Green JP, NJ Newman et al (1993) Cortical blindness and white matter lesions in a patient FK506 after liver transplantation. Neurology 43:2417

    Google Scholar 

  36. Parlevliet KJ, Bemelman FJ, Yong SL et al (1995) Toxicity of OKT3 increases with dosage: A controlled study in renal transplant recipients. Transplant Int 8:141

    CAS  Google Scholar 

  37. Seifeldin RA, Lawrence KR, Rahamtulla AF, AP M (1997) Generalized seizures associated with the use of muromonab-CD3 in two patients after kidney transplantation. Ann Pharmacother 31:586

    PubMed  CAS  Google Scholar 

  38. Dukar O, Barr CC (1993) Visual loss complicating OKT3 monoclonal antibody therapy. Am J Opthalmol 115:781

    CAS  Google Scholar 

  39. De La Camara R, Tomas JF, Figuera A et al (1998) High dose busulfan and seizures. Bone Marrow Transplant 7:363

    Google Scholar 

  40. Jagannath S, Armitage JO, Dicke KA et al (1989) Prognostic factors for response and survival after high-dose cyclophosphamide, carmustine, and etoposide with autologous bone marrow transplantation for relapsed Hodgkins’s disease. J Clin Oncol 7:179

    Google Scholar 

  41. Seifeldin RA (1995) Drug interactions in transplantation. Clin Ther 17:1043

    Article  PubMed  CAS  Google Scholar 

  42. Lowenstein DH, Alldredge BK (1998) Current concepts: status epilepticus. N Eng J Med 338:970–976

    Article  CAS  Google Scholar 

  43. Sinha S, Naritoku DK (2000) Intravenous valproate is well tolerated in unstable patients with status epilepticus. Neurology 55:722–724

    Article  PubMed  CAS  Google Scholar 

  44. Manno EM (2003) New management strategies in the treatment of status epilepticus. Mayo Clin Proc 78:508–518

    Article  PubMed  Google Scholar 

  45. Kreuz W, Linde R, Funk M et al (1992) Valproate therapy induces von Willebrand disease type I. Epilepsia 33:178–184

    Article  PubMed  CAS  Google Scholar 

  46. Glass GA, Stankiewicz J, Mithoefer A, Freeman R, Bergethon PR (2005) Levetiracetam for seizures after liver transplantation. Neurology 64(6):1084–1085

    Article  PubMed  CAS  Google Scholar 

  47. Speeg KV, Halff GA, Schenker S (1995) Metabolsim of drugs before and after liver transplantation. In: Maddrey WC, MF S (eds) Transplantation of the liver, Appleton & Lange, Norwalk, CT, pp 427

    Google Scholar 

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Zakaria, T., Wijdicks, E.F.M., Worrell, G.A. (2010). Seizures in Organ Transplant Recipients. In: Varelas, P. (eds) Seizures in Critical Care. Current Clinical Neurology. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-60327-532-3_8

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  • DOI: https://doi.org/10.1007/978-1-60327-532-3_8

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  • Publisher Name: Humana Press, Totowa, NJ

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  • Online ISBN: 978-1-60327-532-3

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