注射用亚胺培南西司他丁钠诱发老年患者癫痫发作

1例71岁女性患者因怀疑院内感染给予亚胺培南西司他丁钠0.5 g,1次/8 h静脉滴注。第3天,患者突然出现抽搐、角弓反张、牙关紧闭,伴意识欠清、喘憋,持续约2~3 min,未予处理自行缓解。约15 min后上述症状再现,1~2 min后自行恢复正常。约75 min及2 h后症状再发,持续时间为3~5 min,两次均给予地西泮及醒脑静。第4次发作后约50 min上述症状再次发作,给予苯巴比妥效果欠佳,换用丙戊酸钠400 mg静脉泵入。约1 h后患者安静入睡。次日停用亚胺培南西司他丁钠,改为拉氧头孢钠,患者未再出现抽搐。

Injectable imipenem-cilastatin sodium-induced seizures in elderly patient

A 71-year-old woman received an Ⅳ infusion of imipenem-cilastatin sodium 0.5 g every 8 hours for suspicious hospital-acquired infection.On day 3,the patient suddenly developed convulsion, opisthotonos,and trismus complicated within unconsciousness and shortness of breath.The symptoms lasted 2~3 minutes and this attack was relieved spontaneously without any treatment.About 15 minutes later,the above symptoms recurred and,1~2 minutes later,she returned to normal status spontaneously.About 75 minutes and 2 hours later,the symptoms reappeared respectively lasting for 3-5 minutes and both diazepam and Xingnaojing（醒脑静） were given.About 50 minutes after the fourth seizure,the above-mentioned attack recurred and phenobarbitone was changed to an Ⅳ infusion of sodium valproate 400 mg via pump due to poor effect.About one hour later,the patient fell asleep quietly.The next day,imipenem-cilastatin sodium was discontinued and switched to latamoxef sodium and she did not experienced seizure anymore.