Abstract
Critically ill patients are prescribed numerous medications during their ICU stay. Some of them have epileptogenic potentials. The most common pathophysiologic mechanism is through GABA receptor blockade and the most commonly used family of ICU drugs, reducing the seizure threshold, is antibiotics. The exact role that these medications play in inducing a clinical or subclinical seizure, in the context of cerebral injury or other multi-organ failure, is in many cases unclear. The best treatment of drug-induced seizures is increased vigilance and prevention. Cautious measures should be used to minimize or eliminate any unwanted drug side effects by attempting to start and keep the patient on the lowest effective dose for the desired therapeutic effect. When upward dosage titration is necessary it is best to increase slowly while keeping a watchful eye on all laboratory and clinical indicators of success or failure. Free levels of antiepileptic or other medications should be considered in the critically ill, due to numerous factors affecting their final action on the pharmacologic target. If a seizure occurs, clinicians should always seek a medication as the cause of the witnessed seizure and should consider replacing it with another agent that has less epileptogenic potential. Lastly, a GABAergic receptor agonist antiepileptic drug should be used as first-line antidote in most of the cases.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Lazarou J, Pomeranz BH, Corey PN. Incidence of adverse drug reactions in hospitalized patients: a meta-analysis of prospective studies. JAMA. 1998;279:1200–5.
Suh DC, Woodall BS, Shin SK, Hermes-De Santis ER. Clinical and economic impact of adverse drug reactions in hospitalized patients. Ann Pharmacother. 2000;34:1373–9.
Classen DC, Pestotnik SL, Evans RS, Lloyd JF, Burke JP. Adverse drug events in hospitalized patients. Excess length of stay, extra costs, and attributable mortality. JAMA. 1997;277:301–6.
Bates DW, Spell N, Cullen DJ, et al. The costs of adverse drug events in hospitalized patients. Adverse Drug Events Prevention Study Group. JAMA. 1997;277:307–11.
Smith KM, Jeske CS, Young B, Hatton J. Prevalence and characteristics of adverse drug reactions in neurosurgical intensive care patients. Neurosurgery. 2006;58:426–33. discussion -33
Bleck TP, Smith MC, Pierre-Louis SJ, Jares JJ, Murray J, Hansen CA. Neurologic complications of critical medical illnesses. Crit Care Med. 1993;21:98–103.
Thundiyil JG, Rowley F, Papa L, Olson KR, Kearney TE. Risk factors for complications of drug-induced seizures. J Med Toxicol. 2011;7:16–23.
Drug Abuse Warning Network, 2005:National Estimates of Drug-Related Emergency Department Visits. Substance Abuse and Mental Health Services Administration, 2007. (Accessed. October 15, 2015)
Drug-induced convulsions. Report from Boston collaborative drug surveillance program. Lancet. 1972;2:677–9.
Lowenstein DH, Alldredge BK. Status epilepticus at an urban public hospital in the 1980s. Neurology. 1993;43:483–8.
Pesola GR, Avasarala J. Bupropion seizure proportion among new-onset generalized seizures and drug related seizures presenting to an emergency department. J Emerg Med. 2002;22:235–9.
Thundiyil JG, Kearney TE, Olson KR. Evolving epidemiology of drug-induced seizures reported to a Poison Control Center System. J Med Toxicol. 2007;3:15–9.
Olson KR, Kearney TE, Dyer JE, Benowitz NL, Blanc PD. Seizures associated with poisoning and drug overdose. Am J Emerg Med. 1994;12:392–5.
Messing RO, Closson RG, Simon RP. Drug-induced seizures: a 10-year experience. Neurology. 1984;34:1582–6.
Wijdicks EF, Sharbrough FW. New-onset seizures in critically ill patients. Neurology. 1993;43:1042–4.
Isbister GK, Downes F, Sibbritt D, Dawson AH, Whyte IM. Aspiration pneumonitis in an overdose population: frequency, predictors, and outcomes. Crit Care Med. 2004;32:88–93.
Finkelstein Y, Hutson JR, Freedman SB, Wax P, Brent J, Toxicology Investigators Consortium Case R. Drug-induced seizures in children and adolescents presenting for emergency care: current and emerging trends. Clin Toxicol. 2013;51:761–6.
Delanty N, Vaughan CJ, French JA. Medical causes of seizures. Lancet. 1998;352:383–90.
Kunisaki TA, Augenstein WL. Drug- and toxin-induced seizures. Emerg Med Clin North Am. 1994;12:1027–56.
Garcia PA, Alldredge BK. Drug-induced seizures. Neurol Clin. 1994;12:85–99.
Alldredge BK. Drug-induced seizures: controversies in their identification and management. Pharmacotherapy. 1997;17:857–60.
Phillips KA, Veenstra DL, Oren E, Lee JK, Sadee W. Potential role of pharmacogenomics in reducing adverse drug reactions: a systematic review. JAMA. 2001;286:2270–9.
Vuilleumier PH, Stamer UM, Landau R. Pharmacogenomic considerations in opioid analgesia. Pharmacogen Personal Med. 2012;5:73–87.
Gasche Y, Daali Y, Fathi M, et al. Codeine intoxication associated with ultrarapid CYP2D6 metabolism. N Engl J Med. 2004;351:2827–31.
Stamer UM, Stuber F. Codeine induced respiratory depression in a child. Paediatr Anaesth. 2008;18:272–3. author reply 5-6
Allen JM, Gelot S. Pharmacogenomics in the intensive care unit: focus on potential implications for clinical practice. Recent Patents Biotechnol. 2014;8:116–22.
Yip VL, Hawcutt DB, Pirmohamed M. Pharmacogenetic Markers of Drug Efficacy and Toxicity. Clin Pharmacol Ther. 2015;98:61–70.
Wills B, Erickson T. Chemically induced seizures. Clin Lab Med. 2006;26:185–209. ix
Haber GW, Litman RS. Generalized tonic-clonic activity after remifentanil administration. Anesth Analg. 2001;93:1532–3. table of contents
Ross J, Kearse Jr LA, Barlow MK, Houghton KJ, Cosgrove GR. Alfentanil-induced epileptiform activity: a simultaneous surface and depth electroencephalographic study in complex partial epilepsy. Epilepsia. 2001;42:220–5.
Sprung J, Schedewie HK. Apparent focal motor seizure with a jacksonian march induced by fentanyl: a case report and review of the literature. J Clin Anesth. 1992;4:139–43.
Tempelhoff R, Modica PA, Bernardo KL, Edwards I. Fentanyl-induced electrocorticographic seizures in patients with complex partial epilepsy. J Neurosurg. 1992;77:201–8.
Sinz EH, Kofke WA, Garman RH. Phenytoin, midazolam, and naloxone protect against fentanyl-induced brain damage in rats. Anesth Analg. 2000;91:1443–9.
Smith NT, Benthuysen JL, Bickford RG, et al. Seizures during opioid anesthetic induction--are they opioid-induced rigidity? Anesthesiology. 1989;71:852–62.
Lupica CR. Delta and mu enkephalins inhibit spontaneous GABA-mediated IPSCs via a cyclic AMP-independent mechanism in the rat hippocampus. J Neurosci Off J Soc Neurosci. 1995;15:737–49.
Svoboda KR, Lupica CR. Opioid inhibition of hippocampal interneurons via modulation of potassium and hyperpolarization-activated cation (Ih) currents. J Neurosci Off J Soc Neurosci. 1998;18:7084–98.
Parkinson SK, Bailey SL, Little WL, Mueller JB. Myoclonic seizure activity with chronic high-dose spinal opioid administration. Anesthesiology. 1990;72:743–5.
Shih CJ, Doufas AG, Chang HC, Lin CM. Recurrent seizure activity after epidural morphine in a post-partum woman. Can J Anaesth. 2005;52:727–9.
Gozdemir M, Muslu B, Usta B, Sert H, Demircioglu RI, Gumus II. Generalized seizure in patient receiving epidural meperidine during cesarean section. Ann Pharmacother. 2008;42:1145.
Armstrong PJ, Bersten A. Normeperidine toxicity. Anesth Analg. 1986;65:536–8.
Knight B, Thomson N, Perry G. Seizures due to norpethidine toxicity. Aust NZ J Med. 2000;30:513.
Mather LE, Tucker GT. Systemic availability of orally administered meperidine. Clin Pharmacol Ther. 1976;20:535–40.
Kaiko RF, Foley KM, Grabinski PY, et al. Central nervous system excitatory effects of meperidine in cancer patients. Ann Neurol. 1983;13:180–5.
Modica PA, Tempelhoff R, White PF. Pro- and anticonvulsant effects of anesthetics (Part I). Anesth Analg. 1990;70:303–15.
Koren G, Butt W, Chinyanga H, Soldin S, Tan YK, Pape K. Postoperative morphine infusion in newborn infants: assessment of disposition characteristics and safety. J Pediatr. 1985;107:963–7.
Brian Jr JE, Seifen AB. Tonic-clonic activity after sufentanil. Anesth Analg. 1987;66:481.
Katz RI, Eide TR, Hartman A, Poppers PJ. Two instances of seizure-like activity in the same patient associated with two different narcotics. Anesth Analg. 1988;67:289–90.
Rao TL, Mummaneni N, El-Etr AA. Convulsions: an unusual response to intravenous fentanyl administration. Anesth Analg. 1982;61:1020–1.
Safwat AM, Daniel D. Grand mal seizure after fentanyl administration. Anesthesiology. 1983;59:78.
Strong WE, Matson M. Probable seizure after alfentanil. Anesth Analg. 1989;68:692–3.
Murkin JM, Moldenhauer CC, Hug Jr CC, Epstein CM. Absence of seizures during induction of anesthesia with high-dose fentanyl. Anesth Analg. 1984;63:489–94.
Sebel PS, Bovill JG, Wauquier A, Rog P. Effects of high-dose fentanyl anesthesia on the electroencephalogram. Anesthesiology. 1981;55:203–11.
Gardner JS, Blough D, Drinkard CR, et al. Tramadol and seizures: a surveillance study in a managed care population. Pharmacotherapy. 2000;20:1423–31.
Marquardt KA, Alsop JA, Albertson TE. Tramadol exposures reported to statewide poison control system. Ann Pharmacother. 2005;39:1039–44.
Spiller HA, Gorman SE, Villalobos D, et al. Prospective multicenter evaluation of tramadol exposure. Journal of. toxicology. 1997;35:361–4.
Talaie H, Panahandeh R, Fayaznouri M, Asadi Z, Abdollahi M. Dose-independent occurrence of seizure with tramadol. J Med Toxicol. 2009;5:63–7.
Shadnia S, Brent J, Mousavi-Fatemi K, Hafezi P, Soltaninejad K. Recurrent seizures in tramadol intoxication: implications for therapy based on 100 patients. Basic Clin Pharmacol Toxicol. 2012;111:133–6.
Kahn LH, Alderfer RJ, Graham DJ. Seizures reported with tramadol. JAMA. 1997;278:1661.
Gasse C, Derby L, Vasilakis-Scaramozza C, Jick H. Incidence of first-time idiopathic seizures in users of tramadol. Pharmacotherapy. 2000;20:629–34.
Saidi H, Ghadiri M, Abbasi S, Ahmadi SF. Efficacy and safety of naloxone in the management of postseizure complaints of tramadol intoxicated patients: a self-controlled study. Emerg Med J EMJ. 2010;27:928–30.
Smolen A, Smolen TN, van de Kamp JL. The effect of naloxone administration on pregnancy-associated seizures. Life Sci. 1986;38:1899–905.
Eizadi-Mood N, Ozcan D, Sabzghabaee AM, Mirmoghtadaee P, Hedaiaty M. Does naloxone prevent seizure in tramadol intoxicated patients? Int J Prev Med. 2014;5:302–7.
Tsutaoka BT, Ho RY, Fung SM, Kearney TE. Comparative toxicity of tapentadol and tramadol utilizing data reported to the national poison data system. Ann Pharmacother. 2015;49:1311–6.
Quail AW. Modern inhalational anaesthetic agents. A review of halothane, isoflurane and enflurane. Med J Aust. 1989;150:95–102.
Julien RM, Kavan EM, Elliott HW. Effects of volatile anaesthetic agents on EEG activity recorded in limbic and sensory systems. Can Anaes Soc J. 1972;19:263–9.
Jenkins J, Milne AC. Convulsive reaction following enflurane anaesthesia. Anaesthesia. 1984;39:44–5.
Rosen I, Soderberg M. Electroencephalographic activity in children under enflurane anesthesia. Acta Anaesthesiol Scand. 1975;19:361–9.
Ohm WW, Cullen BF, Amory DW, Kennedy RD. Delayed seizure activity following enflurane anesthesia. Anesthesiology. 1975;42:367–8.
Kruczek M, Albin MS, Wolf S, Bertoni JM. Postoperative seizure activity following enflurane anesthesia. Anesthesiology. 1980;53:175–6.
Burchiel KJ, Stockard JJ, Calverley RK, Smith NT. Relationship of pre- and postanesthetic EEG abnormalities to enflurane-induced seizure activity. Anesth Analg. 1977;56:509–14.
Michenfelder JD, Cucchiara RF. Canine cerebral oxygen consumption during enflurane anesthesia and its modification during induced seizures. Anesthesiology. 1974;40:575–80.
Yamashiro M, Sumitomo M, Furuya H. Paroxysmal electroencephalographic discharges during enflurane anaesthesia in patients with a history of cerebral convulsions. Br J Anaesth. 1985;57:1029–37.
Hymes JA. Seizure activity during isoflurane anesthesia. Anesth Analg. 1985;64:367–8.
Harrison JL. Postoperative seizures after isoflurane anesthesia. Anesth Analg. 1986;65:1235–6.
Kofke WA, Young RS, Davis P, et al. Isoflurane for refractory status epilepticus: a clinical series. Anesthesiology. 1989;71:653–9.
Kofke WA, Snider MT, Young RS, Ramer JC. Prolonged low flow isoflurane anesthesia for status epilepticus. Anesthesiology. 1985;62:653–6.
Yli-Hankala A, Vakkuri A, Sarkela M, Lindgren L, Korttila K, Jantti V. Epileptiform electroencephalogram during mask induction of anesthesia with sevoflurane. Anesthesiology. 1999;91:1596–603.
Jantti V, Yli-Hankala A, Vakkuri A. The epileptogenic property of sevoflurane and in patients without epilepsy. Anesth Analg. 2001;92:1359.
Vakkuri A, Yli-Hankala A, Sarkela M, et al. Sevoflurane mask induction of anaesthesia is associated with epileptiform EEG in children. Acta Anaesthesiol Scand. 2001;45:805–11.
Jaaskelainen SK, Kaisti K, Suni L, Hinkka S, Scheinin H. Sevoflurane is epileptogenic in healthy subjects at surgical levels of anesthesia. Neurology. 2003;61:1073–8.
Constant I, Seeman R, Murat I. Sevoflurane and epileptiform EEG changes. Paediatr Anaesth. 2005;15:266–74.
Mohanram A, Kumar V, Iqbal Z, Markan S, Pagel PS. Repetitive generalized seizure-like activity during emergence from sevoflurane anesthesia. Can J Anaesth. 2007;54:657–61.
Woodforth IJ, Hicks RG, Crawford MR, Stephen JP, Burke DJ. Electroencephalographic evidence of seizure activity under deep sevoflurane anesthesia in a nonepileptic patient. Anesthesiology. 1997;87:1579–82.
Julliac B, Guehl D, Chopin F, et al. Risk factors for the occurrence of electroencephalogram abnormalities during induction of anesthesia with sevoflurane in nonepileptic patients. Anesthesiology. 2007;106:243–51.
Iijima T, Nakamura Z, Iwao Y, Sankawa H. The epileptogenic properties of the volatile anesthetics sevoflurane and isoflurane in patients with epilepsy. Anesth Analg. 2000;91:989–95.
Rudo FG, Krantz Jr JC. Anaesthetic molecules. Br J Anaesth. 1974;46:181–9.
Corssen G, Little SC, Tavakoli M. Ketamine and epilepsy. Anesth Analg. 1974;53:319–35.
Steen PA, Michenfelder JD. Neurotoxicity of anesthetics. Anesthesiology. 1979;50:437–53.
Ferrer-Allado T, Brechner VL, Dymond A, Cozen H, Crandall P. Ketamine-induced electroconvulsive phenomena in the human limbic and thalamic regions. Anesthesiology. 1973;38:333–44.
Bennett DR, Madsen JA, Jordan WS, Wiser WC. Ketamine anesthesia in brain-damaged epileptics. Electroencephalographic and clinical observations. Neurology. 1973;23:449–60.
Sheth RD, Gidal BE. Refractory status epilepticus: response to ketamine. Neurology. 1998;51:1765–6.
Laughlin TP, Newberg LA. Prolonged myoclonus after etomidate anesthesia. Anesth Analg. 1985;64:80–2.
Ghoneim MM, Yamada T. Etomidate: a clinical and electroencephalographic comparison with thiopental. Anesth Analg. 1977;56:479–85.
Krieger W, Copperman J, Laxer KD. Seizures with etomidate anesthesia. Anesth Analg. 1985;64:1226–7.
Ebrahim ZY, DeBoer GE, Luders H, Hahn JF, Lesser RP. Effect of etomidate on the electroencephalogram of patients with epilepsy. Anesth Analg. 1986;65:1004–6.
Sutherland MJ, Burt P. Propofol and seizures. Anaesth Intensive Care. 1994;22:733–7.
Walder B, Tramer MR, Seeck M. Seizure-like phenomena and propofol: a systematic review. Neurology. 2002;58:1327–32.
Bevan JC. Propofol-related convulsions. Can J Anaesth. 1993;40:805–9.
Blumer J, Strong JM, Atkinson Jr AJ. The convulsant potency of lidocaine and its N-dealkylated metabolites. J Pharmacol Exp Ther. 1973;186:31–6.
Lemmen LJ, Klassen M, Duiser B. Intravenous lidocaine in the treatment of convulsions. JAMA. 1978;239:2025.
Bernhard CG, Bohm E. On the effects of xylocain on the central nervous system with special reference to its influence on epileptic phenomena. Experientia. 1954;10:474–6.
Reynolds F. Adverse effects of local anaesthetics. Br J Anaesth. 1987;59:78–95.
Varelas PN, Mirski MA. Seizures in the adult intensive care unit. J Neurosurg Anesthesiol. 2001;13:163–75.
Ochs HR, Carstens G, Greenblatt DJ. Reduction in lidocaine clearance during continuous infusion and by coadministration of propranolol. N Engl J Med. 1980;303:373–7.
Feely J, Wilkinson GR, McAllister CB, Wood AJ. Increased toxicity and reduced clearance of lidocaine by cimetidine. Ann Intern Med. 1982;96:592–4.
Bauer J. Seizure-inducing effects of antiepileptic drugs: a review. Acta Neurol Scand. 1996;94:367–77.
Gayatri NA, Livingston JH. Aggravation of epilepsy by anti-epileptic drugs. Dev Med Child Neurol. 2006;48:394–8.
Gelisse P, Genton P, Kuate C, Pesenti A, Baldy-Moulinier M, Crespel A. Worsening of seizures by oxcarbazepine in juvenile idiopathic generalized epilepsies. Epilepsia. 2004;45:1282–6.
Fink MP, Snydman DR, Niederman MS, et al. Treatment of severe pneumonia in hospitalized patients: results of a multicenter, randomized, double-blind trial comparing intravenous ciprofloxacin with imipenem-cilastatin. The Severe Pneumonia Study Group. Antimicrob Agents Chemother. 1994;38:547–57.
Weaver DF, Camfield P, Fraser A. Massive carbamazepine overdose: clinical and pharmacologic observations in five episodes. Neurology. 1988;38:755–9.
Wilkus RJ, Dodrill CB, Troupin AS. Carbamazepine and the electroencephalogram of epileptics: a double blind study in comparison to phenytoin. Epilepsia. 1978;19:283–91.
Milligan N, Oxley J, Richens A. Acute effects of intravenous phenytoin on the frequency of inter-ictal spikes in man. Br J Clin Pharmacol. 1983;16:285–9.
Schachter SC. Iatrogenic seizures. Neurol Clin. 1998;16:157–70.
Walker AE, Johnson HC. Convulsive factor in commercial penicillin. Arch Surg. 1945;50:69–73.
Porter J, Jick H. Drug-induced anaphylaxis, convulsions, deafness, and extrapyramidal symptoms. Lancet. 1977;1:587–8.
Gutnick MJ, Van Duijn H, Citri N. Relative convulsant potencies of structural analogues of penicillin. Brain Res. 1976;114:139–43.
Fossieck Jr B, Parker RH. Neurotoxicity during intravenous infusion of penicillin. A review. J Clin Pharmacol. 1974;14:504–12.
Nicholls PJ. Neurotoxicity of penicillin. J Antimicrob Chemother. 1980;6:161–5.
Barrons RW, Murray KM, Richey RM. Populations at risk for penicillin-induced seizures. Ann Pharmacother. 1992;26:26–9.
Wallace KL. Antibiotic-induced convulsions. Crit Care Clin. 1997;13:741–62.
De Sarro A, De Sarro GB, Ascioti C, Nistico G. Epileptogenic activity of some beta-lactam derivatives: structure-activity relationship. Neuropharmacology. 1989;28:359–65.
Bechtel TP, Slaughter RL, Moore TD. Seizures associated with high cerebrospinal fluid concentrations of cefazolin. Am J Hosp Pharm. 1980;37:271–3.
Grill MF, Maganti R. Cephalosporin-induced neurotoxicity: clinical manifestations, potential pathogenic mechanisms, and the role of electroencephalographic monitoring. Ann Pharmacother. 2008;42:1843–50.
Dakdouki GK, Al-Awar GN. Cefepime-induced encephalopathy. Int J Infect Dis: IJID. 2004;8:59–61.
Fernandez-Torre JL, Martinez-Martinez M, Gonzalez-Rato J, et al. Cephalosporin-induced nonconvulsive status epilepticus: clinical and electroencephalographic features. Epilepsia. 2005;46:1550–2.
Naeije G, Lorent S, Vincent JL, Legros B. Continuous epileptiform discharges in patients treated with cefepime or meropenem. Arch Neurol. 2011;68:1303–7.
Norrby SR. Neurotoxicity of carbapenem antibacterials. Drug Saf. 1996;15:87–90.
Schliamser SE, Broholm KA, Liljedahl AL, Norrby SR. Comparative neurotoxicity of benzylpenicillin, imipenem/cilastatin and FCE 22101, a new injectible penem. J Antimicrob Chemother. 1988;22:687–95.
Calandra G, Lydick E, Carrigan J, Weiss L, Guess H. Factors predisposing to seizures in seriously ill infected patients receiving antibiotics: experience with imipenem/cilastatin. Am J Med. 1988;84:911–8.
Pestotnik SL, Classen DC, Evans RS, Stevens LE, Burke JP. Prospective surveillance of imipenem/cilastatin use and associated seizures using a hospital information system. Ann Pharmacother. 1993;27:497–501.
Norrby SR, Gildon KM. Safety profile of meropenem: a review of nearly 5, 000 patients treated with meropenem. Scand J Infect Dis. 1999;31:3–10.
Christ W. Central nervous system toxicity of quinolones: human and animal findings. J Antimicrob Chemother. 1990;26(Suppl B):219–25.
Akahane K, Sekiguchi M, Une T, Osada Y. Structure-epileptogenicity relationship of quinolones with special reference to their interaction with gamma-aminobutyric acid receptor sites. Antimicrob Agents Chemother. 1989;33:1704–8.
Christie MJ, Wong K, Ting RH, Tam PY, Sikaneta TG. Generalized seizure and toxic epidermal necrolysis following levofloxacin exposure. Ann Pharmacother. 2005;39:953–5.
O’Donnell JA, Gelone SP. Fluoroquinolones. Infect Dis Clin N Am. 2000;14:489–513. xi
Lietman PS. Fluoroquinolone toxicities. An update. Drugs. 1995;49(Suppl 2):159–63.
Schwartz MT, Calvert JF. Potential neurologic toxicity related to ciprofloxacin. DICP. 1990;24:138–40.
Slavich IL, Gleffe RF, Haas EJ. Grand mal epileptic seizures during ciprofloxacin therapy. JAMA. 1989;261:558–9.
Coyer JR, Nicholson DP. Isoniazid-induced convulsions. South Med J. 1976;69:294–7.
Devadatta S. Isoniazid-induced encephalopathy. Lancet. 1965;2:440.
Mahler ME. Seizures: common causes and treatment in the elderly. Geriatrics. 1987;42:73–8.
Orlowski JP, Paganini EP, Pippenger CE. Treatment of a potentially lethal dose isoniazid ingestion. Ann Emerg Med. 1988;17:73–6.
Nelson LG. Grand mal seizures following overdose of isoniazid. a report of four cases. Am Rev Respir Dis. 1965;91:600–4.
Alvarez FG, Guntupalli KK. Isoniazid overdose: four case reports and review of the literature. Intensive Care Med. 1995;21:641–4.
Wason S, Lacouture PG, Lovejoy Jr FH. Single high-dose pyridoxine treatment for isoniazid overdose. JAMA. 1981;246:1102–4.
Frytak S, Moertel CH, Childs DS. Neurologic toxicity associated with high-dose metronidazole therapy. Ann Intern Med. 1978;88:361–2.
Kusumi RK, Plouffe JF, Wyatt RH, Fass RJ. Central nervous system toxicity associated with metronidazole therapy. Ann Intern Med. 1980;93:59–60.
Bailes J, Willis J, Priebe C, Strub R. Encephalopathy with metronidazole in a child. Am J Dis child (1960). 1983;137:290–1.
Semel JD, Allen N. Seizures in patients simultaneously receiving theophylline and imipenem or ciprofloxacin or metronidazole. South Med J. 1991;84:465–8.
Jayaweera DT. Minimising the dosage-limiting toxicities of foscarnet induction therapy. Drug Saf. 1997;16:258–66.
Kitching AR, Fagg D, Hay NM, Hatfield PJ, Macdonald A. Neurotoxicity associated with acyclovir in end stage renal failure. New Zealand Med J. 1997;110:167–9.
Rashiq S, Briewa L, Mooney M, Giancarlo T, Khatib R, Wilson FM. Distinguishing acyclovir neurotoxicity from encephalomyelitis. J Intern Med. 1993;234:507–11.
Barton TL, Roush MK, Dever LL. Seizures associated with ganciclovir therapy. Pharmacotherapy. 1992;12:413–5.
Pascual-Sedano B, Iranzo A, Marti-Fabregas J, et al. Prospective study of new-onset seizures in patients with human immunodeficiency virus infection: etiologic and clinical aspects. Arch Neurol. 1999;56:609–12.
Romanelli F, Jennings HR, Nath A, Ryan M, Berger J. Therapeutic dilemma: the use of anticonvulsants in HIV-positive individuals. Neurology. 2000;54:1404–7.
Zwillich CW, Sutton FD, Neff TA, Cohn WM, Matthay RA, Weinberger MM. Theophylline-induced seizures in adults. Correlation with serum concentrations. Ann Intern Med. 1975;82:784–7.
Bahls FH, Ma KK, Bird TD. Theophylline-associated seizures with “therapeutic” or low toxic serum concentrations: risk factors for serious outcome in adults. Neurology. 1991;41:1309–12.
Gaudreault P, Guay J. Theophylline poisoning. Pharmacological considerations and clinical management. Med Toxicol. 1986;1:169–91.
Aitken ML, Martin TR. Life-threatening theophylline toxicity is not predictable by serum levels. Chest. 1987;91:10–4.
Paloucek FP, Rodvold KA. Evaluation of theophylline overdoses and toxicities. Ann Emerg Med. 1988;17:135–44.
Zaccara G, Muscas GC, Messori A. Clinical features, pathogenesis and management of drug-induced seizures. Drug Saf. 1990;5:109–51.
Henderson A, Wright DM, Pond SM. Management of theophylline overdose patients in the intensive care unit. Anaesth Intensive Care. 1992;20:56–62.
Olson KR, Benowitz NL, Woo OF, Pond SM. Theophylline overdose: acute single ingestion versus chronic repeated overmedication. Am J Emerg Med. 1985;3:386–94.
Kumar A, Bleck TP. Intravenous midazolam for the treatment of refractory status epilepticus. Crit Care Med. 1992;20:483–8.
Scott JP, Higenbottam TW. Adverse reactions and interactions of cyclosporin. Med Toxicol Adv Drug Exp. 1988;3:107–27.
Gilmore RL. Seizures and antiepileptic drug use in transplant patients. Neurol Clin. 1988;6:279–96.
Truwit CL, Denaro CP, Lake JR, DeMarco T. MR imaging of reversible cyclosporin A-induced neurotoxicity. AJNR. 1991;12:651–9.
Glass GA, Stankiewicz J, Mithoefer A, Freeman R, Bergethon PR. Levetiracetam for seizures after liver transplantation. Neurology. 2005;64:1084–5.
Ekberg H, Grinyo J, Nashan B, et al. Cyclosporine sparing with mycophenolate mofetil, daclizumab and corticosteroids in renal allograft recipients: the CAESAR Study. Am J Transplant. 2007;7:560–70.
Maramattom BV, Wijdicks EF. Sirolimus may not cause neurotoxicity in kidney and liver transplant recipients. Neurology. 2004;63:1958–9.
Thistlethwaite Jr JR, Stuart JK, Mayes JT, et al. Complications and monitoring of OKT3 therapy. Am J Kidney Dis. 1988;11:112–9.
Kay HE, Knapton PJ, O’Sullivan JP, et al. Encephalopathy in acute leukaemia associated with methotrexate therapy. Arch Dis Child. 1972;47:344–54.
Johnson FL, Bernstein ID, Hartmann JR, Chard Jr RL. Seizures associated with vincristine sulfate therapy. J Pediatr. 1973;82:699–702.
Singh G, Rees JH, Sander JW. Seizures and epilepsy in oncological practice: causes, course, mechanisms and treatment. J Neurol Neurosurg Psychiatry. 2007;78:342–9.
Pisani F, Oteri G, Costa C, Di Raimondo G, Di Perri R. Effects of psychotropic drugs on seizure threshold. Drug Saf. 2002;25:91–110.
Alldredge BK. Seizure risk associated with psychotropic drugs: clinical and pharmacokinetic considerations. Neurology. 1999;53:S68–75.
Logothetis J. Spontaneous epileptic seizures and electroencephalographic changes in the course of phenothiazine therapy. Neurology. 1967;17:869–77.
Cold JA, Wells BG, Froemming JH. Seizure activity associated with antipsychotic therapy. DICP. 1990;24:601–6.
Remick RA, Fine SH. Antipsychotic drugs and seizures. The Journal of clinical psychiatry. 1979;40:78–80.
Chase PB, Biros MH. A retrospective review of the use and safety of droperidol in a large, high-risk, inner-city emergency department patient population. Acad Emerg Med Off J Soc Acad Emerg Med. 2002;9:1402–10.
Devinsky O, Honigfeld G, Patin J. Clozapine-related seizures. Neurology. 1991;41:369–71.
Ereshefsky L, Watanabe MD, Tran-Johnson TK. Clozapine: an atypical antipsychotic agent. Clin Pharm. 1989;8:691–709.
Wilson WH, Claussen AM. Seizures associated with clozapine treatment in a state hospital. The Journal of clinical psychiatry. 1994;55:184–8.
Toth P, Frankenburg FR. Clozapine and seizures: a review. Can J Psychiatr. 1994;39:236–8.
Navarro V, Pons A, Romero A, Bernardo M. Topiramate for clozapine-induced seizures. Am J Psychiatry. 2001;158:968–9.
Centorrino F, Price BH, Tuttle M, et al. EEG abnormalities during treatment with typical and atypical antipsychotics. Am J Psychiatry. 2002;159:109–15.
Amann BL, Pogarell O, Mergl R, et al. EEG abnormalities associated with antipsychotics: a comparison of quetiapine, olanzapine, haloperidol and healthy subjects. Human Psychopharmacol. 2003;18:641–6.
Barnes TR, McPhillips MA. Critical analysis and comparison of the side-effect and safety profiles of the new antipsychotics. Br J Psychiatry. 1999;34-43
Citrome L. New antipsychotic medications: what advantages do they offer? Postgrad Med. 1997;101:207–10. 13-4
Casey DE. The relationship of pharmacology to side effects. The Journal of clinical psychiatry. 1997;58(Suppl 10):55–62.
Hedges D, Jeppson K, Whitehead P. Antipsychotic medication and seizures: a review. Drugs Today (Barc). 2003;39:551–7.
Alper K, Schwartz KA, Kolts RL, Khan A. Seizure incidence in psychopharmacological clinical trials: an analysis of Food and Drug Administration (FDA) summary basis of approval reports. Biol Psychiatry. 2007;62:345–54.
Wyderski RJ, Starrett WG, Abou-Saif A. Fatal status epilepticus associated with olanzapine therapy. Ann Pharmacother. 1999;33:787–9.
Lee JW, Crismon ML, Dorson PG. Seizure associated with olanzapine. Ann Pharmacother. 1999;33:554–6.
Pillmann F, Schlote K, Broich K, Marneros A. Electroencephalogram alterations during treatment with olanzapine. Psychopharmacology. 2000;150:216–9.
Lee KC, Finley PR, Alldredge BK. Risk of seizures associated with psychotropic medications: emphasis on new drugs and new findings. Expert Opin Drug Saf. 2003;2:233–47.
Woolley J, Smith S. Lowered seizure threshold on olanzapine. Br J Psychiatry. 2001;178:85–6.
Rosenstein DL, Nelson JC, Jacobs SC. Seizures associated with antidepressants: a review. The Journal of clinical psychiatry. 1993;54:289–99.
Wedin GP, Oderda GM, Klein-Schwartz W, Gorman RL. Relative toxicity of cyclic antidepressants. Ann Emerg Med. 1986;15:797–804.
Starkey IR, Lawson AA. Poisoning with tricyclic and related antidepressants--a ten-year review. The Quarterly journal of medicine. 1980;49:33–49.
Brooke G, Weatherly JR. Imipramine. Lancet. 1959;2:568–9.
DeVeaugh-Geiss J, Landau P, Katz R. Preliminary results from a multicenter trial of clomipramine in obsessive-compulsive disorder. Psychopharmacol Bull. 1989;25:36–40.
Preskorn SH, Fast GA. Tricyclic antidepressant-induced seizures and plasma drug concentration. J Clin Psy. 1992;53:160–2.
Lowry MR, Dunner FJ. Seizures during tricyclic therapy. Am J Psychiatry. 1980;137:1461–2.
Kulig K, Rumack BH, Sullivan Jr JB, et al. Amoxapine overdose. Coma and seizures without cardiotoxic effects. JAMA. 1982;248:1092–4.
Boehnert MT, Lovejoy Jr FH. Value of the QRS duration versus the serum drug level in predicting seizures and ventricular arrhythmias after an acute overdose of tricyclic antidepressants. N Engl J Med. 1985;313:474–9.
Ellison DW, Pentel PR. Clinical features and consequences of seizures due to cyclic antidepressant overdose. Am J Emerg Med. 1989;7:5–10.
Favale E, Rubino V, Mainardi P, Lunardi G, Albano C. Anticonvulsant effect of fluoxetine in humans. Neurology. 1995;45:1926–7.
Braitberg G, Curry SC. Seizure after isolated fluoxetine overdose. Ann Emerg Med. 1995;26:234–7.
Kelly CA, Dhaun N, Laing WJ, Strachan FE, Good AM, Bateman DN. Comparative toxicity of citalopram and the newer antidepressants after overdose. J Toxicol. 2004;42:67–71.
Akcan A, Sozuer E, Akyildiz H, Ozturk A, Atalay A, Yilmaz Z. Predisposing factors and surgical outcome of complicated liver hydatid cysts. World J Gastroenterol WJG. 2010;16:3040–8.
Bodner RA, Lynch T, Lewis L, Kahn D. Serotonin syndrome. Neurology. 1995;45:219–23.
Carbone JR. The neuroleptic malignant and serotonin syndromes. Emerg Med Clin North Am. 2000;18:317–25. x
Lieberman JA, Kane JM, Reife R. Neuromuscular effects of monoamine oxidase inhibitors. J Clin Psychopharmacol. 1985;5:221–8.
Belson MG, Kelley TR. Bupropion exposures: clinical manifestations and medical outcome. J Emerg Med. 2002;23:223–30.
Davidson J. Seizures and bupropion: a review. The Journal of clinical psychiatry. 1989;50:256–61.
Rissmiller DJ, Campo T. Extended-release bupropion induced grand mal seizures. J Am Osteopathic Assoc. 2007;107:441–2.
Starr PA, Martin AJ, Larson PS. Implantation of deep brain stimulator electrodes using interventional MRI. Neurosurg Clin N Am. 2009;20:193–203.
Nierenberg AA, Cole JO. Antidepressant adverse drug reactions. The Journal of clinical psychiatry. 1991;52(Suppl):40–7.
Johnston JA, Lineberry CG, Ascher JA, et al. A 102-center prospective study of seizure in association with bupropion. The Journal of clinical psychiatry. 1991;52:450–6.
Whyte IM, Dawson AH, Buckley NA. Relative toxicity of venlafaxine and selective serotonin reuptake inhibitors in overdose compared to tricyclic antidepressants. QJM. 2003;96:369–74.
Struve FA. Lithium-specific pathological electroencephalographic changes: a successful replication of earlier investigative results. Clin EEG (electroencephalography). 1987;18:46–53.
Hansen HE, Amdisen A. Lithium intoxication. (Report of 23 cases and review of 100 cases from the literature). Q J Med. 1978;47:123–44.
Okusa MD, Crystal LJ. Clinical manifestations and management of acute lithium intoxication. Am J Med. 1994;97:383–9.
Mayan H, Golubev N, Dinour D, Farfel Z. Lithium intoxication due to carbamazepine-induced renal failure. Ann Pharmacother. 2001;35:560–2.
Shukla S, Godwin CD, Long LE, Miller MG. Lithium-carbamazepine neurotoxicity and risk factors. Am J Psychiatry. 1984;141:1604–6.
Happe S. Excessive daytime sleepiness and sleep disturbances in patients with neurological diseases: epidemiology and management. Drugs. 2003;63:2725–37.
Zagnoni PG, Albano C. Psychostimulants and epilepsy. Epilepsia. 2002;43(Suppl 2):28–31.
Thomas S, Upadhyaya H. Adderall and seizures. J Am Acad Child Adolesc Psychiatry. 2002;41:365.
Hemmer SA, Pasternak JF, Zecker SG, Trommer BL. Stimulant therapy and seizure risk in children with ADHD. Pediatr Neurol. 2001;24:99–102.
Ivanenko A, Tauman R, Gozal D. Modafinil in the treatment of excessive daytime sleepiness in children. Sleep Med. 2003;4:579–82.
Green LB, Nelson VS. Death after acute withdrawal of intrathecal baclofen: case report and literature review. Arch Phys Med Rehabil. 1999;80:1600–4.
Kofler M, Arturo LA. Prolonged seizure activity after baclofen withdrawal. Neurology. 1992;42:697–8.
Greenberg MI, Hendrickson RG. Baclofen withdrawal following removal of an intrathecal baclofen pump despite oral baclofen replacement. Journal of. toxicology. 2003;41:83–5.
Koppel C, Ibe K, Tenczer J. Clinical symptomatology of diphenhydramine overdose: an evaluation of 136 cases in 1982 to 1985. Journal of. toxicology. 1987;25:53–70.
Magera BE, Betlach CJ, Sweatt AP, Derrick Jr CW. Hydroxyzine intoxication in a 13-month-old child. Pediatrics. 1981;67:280–3.
Nelson M, Bartlett RJ, Lamb JT. Seizures after intravenous contrast media for cranial computed tomography. J Neurol Neurosurg Psychiatry. 1989;52:1170–5.
Avrahami E, Weiss-Peretz J, Cohn DF. Focal epileptic activity following intravenous contrast material injection in patients with metastatic brain disease. J Neurol Neurosurg Psychiatry. 1987;50:221–3.
Weinstein RS. Recognition and management of poisoning with beta-adrenergic blocking agents. Ann Emerg Med. 1984;13:1123–31.
Das G, Ferris JC. Generalized convulsions in a patient receiving ultrashort-acting beta-blocker infusion. Drug Intell Clin Pharm. 1988;22:484–5.
Shah AS, Eddleston M. Should phenytoin or barbiturates be used as second-line anticonvulsant therapy for toxicological seizures? Clin Toxicol. 2010;48:800–5.
Varelas PN, Spanaki MV, Mirski MA. Seizures and the neurosurgical intensive care unit. Neurosurg Clin N Am. 2013;24:393–406.
Ziai WC, Kaplan PW. Seizures and status epilepticus in the intensive care unit. Semin Neurol. 2008;28:668–81.
Sabers A, Gram L. Newer anticonvulsants: comparative review of drug interactions and adverse effects. Drugs. 2000;60:23–33.
Franson KL, Hay DP, Neppe V, et al. Drug-induced seizures in the elderly. Causative agents and optimal management. Drugs Aging. 1995;7:38–48.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer International Publishing AG
About this chapter
Cite this chapter
Rhoney, D.H., Shepherd, G. (2017). Drug-Induced Seizures in Critically Ill Patients. In: Varelas, P., Claassen, J. (eds) Seizures in Critical Care. Current Clinical Neurology. Humana Press, Cham. https://doi.org/10.1007/978-3-319-49557-6_20
Download citation
DOI: https://doi.org/10.1007/978-3-319-49557-6_20
Published:
Publisher Name: Humana Press, Cham
Print ISBN: 978-3-319-49555-2
Online ISBN: 978-3-319-49557-6
eBook Packages: MedicineMedicine (R0)