Cephalosporins are a commonly used class of antibiotics in various types of infections. Cefepime, a fourth-generation cephalosporin, has been reported to cause neurotoxicity, which can present itself as varied manifestations. Nonconvulsive status epilepticus (NCSE) is a rare manifestation of this neurotoxicity. This condition often proves difficult to diagnose because it is chiefly an electroencephalogram-based diagnosis. The authors report a case of cefepime-induced NCSE in a 57-year-old female patient with compromised renal status.
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We discuss an interesting case of a 65-year-old man with multiple dissociative episodes which previously had been assessed as fugues. After evaluation in the memory clinic these episodes appeared to be generalized epileptic seizures, with an electro-encephalographic diagnosis of non-convulsive status epilepticus. Throughout this case, the different features that characterize an epileptic versus a psychiatric etiology are being discussed as well as other differential diagnostic considerations.
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