Annals of Rehabilitation Medicine

"Neurotoxicity"

Case Report

Cefepime Neurotoxicity in Patients with Renal Insufficiency: Seon-Yu Kim, In-Sik Lee, Seung Lee Park, Jongmin Lee; Ann Rehabil Med 2012;36(1):159-162. Published online February 29, 2012; DOI: https://doi.org/10.5535/arm.2012.36.1.159

Abstract
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Cefepime is a fourth-generation cephalosporin that is active against both gram-positive and gram-negative organisms. It is administered parenterally for the treatment of severe infections. Approximately 85% of the drug is excreted unchanged by the kidneys. Neurotoxicity in patients with renal failure who are treated with cefepime has been reported sporadically. We report on two senile patients with renal impairment who developed neurotoxicity including lethal outcome after treatment with cefepime.

Citations

Citations to this article as recorded by

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Original Article

The Evaluation of Neurotoxicity after Intrathecal Restorative Fluid Injection in the Rat.: Kim, Gui Sang , Yoon, Joon Sik , Kim, Sei Joo , Seo, Gwan Sik , Lee, Sang Hun , Baek, Hye Jin , Lee, Joo Han , Kim, Joo Han , Kim, Don Kyu; J Korean Acad Rehabil Med 2007;31(2):150-156.

Abstract
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Objective
To assess neurotoxicity of intrathecal restorative fluid leakage in the course of the intradiscal restorative fluid injection. Method: Twenty male Sprague-Dawley rats, body weight range of 300∼350 gm, were divided randomly into four groups. Control group, group A (mixed solution of glucosamine hydrochloride 5%, chondroitin sulfate 5%, and bupivacaine hydrochloride 2%), group B (glucosamine hydrochloride 8%, chondroitin sulfate 2%, and bupivacaine hydrochloride 2%) and group C (glucosamine hydrochloride 16%, chondroitin sulfate 2%, and bupivacaine hydrochloride 2%). The behavioral test for cold allodynia (tail flick test) was conducted 1 day prior to the injection and 7 days postoperatively. Histopathologic evaluation was performed using light microscopy by a neuropathologist. The severity of nerve and cord injury were graded according to injury scoring system. Results: Each group showed no significant difference in sensory function test using tail flick test before and after intrathecal restorative fluid injection. Cold allodynia was not showed statistically significant difference among the group. Histological examination showed statistically significant difference between control group and group B, group C, and between group A and group B, C in both cord and root. Conclusion: Intrathecal injection of restorative fluid shows neurotoxic changes in roots and spinal cord in histopathologic studies. Although same ingredients of restorative solution, the different concentration of the ingredients revealed different neurotoxicity. (J Korean Acad Rehab Med 2007; 31: 150-156)