Cargando…

Non-convulsive status epilepticus possibly induced by a rapid correction of severe hyperkalemia: a case report and literature review

BACKGROUND: Patients with chronic kidney disease frequently develop neurological complications including confusion and altered consciousness. Non-convulsive status epilepticus, which is characterized by a change in behavior and/or mental process accompanied by epileptiform discharges on electroencep...

Descripción completa

Detalles Bibliográficos
Autores principales: Bussaka, Saki, Suehiro, Takaichi, Mitsuiki, Koji, Morioka, Takato, Shono, Tadahisa, Fujiki, Fujio, Nakano, Toshiaki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084670/
https://www.ncbi.nlm.nih.gov/pubmed/37038101
http://dx.doi.org/10.1186/s12882-023-03141-1
_version_ 1785021788458057728
author Bussaka, Saki
Suehiro, Takaichi
Mitsuiki, Koji
Morioka, Takato
Shono, Tadahisa
Fujiki, Fujio
Nakano, Toshiaki
author_facet Bussaka, Saki
Suehiro, Takaichi
Mitsuiki, Koji
Morioka, Takato
Shono, Tadahisa
Fujiki, Fujio
Nakano, Toshiaki
author_sort Bussaka, Saki
collection PubMed
description BACKGROUND: Patients with chronic kidney disease frequently develop neurological complications including confusion and altered consciousness. Non-convulsive status epilepticus, which is characterized by a change in behavior and/or mental process accompanied by epileptiform discharges on electroencephalogram in the absence of convulsive seizures, is one of the overlooked causes of altered consciousness. The incidence and precise pathophysiological mechanism of non-convulsive status epilepticus in patients with kidney disease, and especially in patients with electrolyte disturbances, remains unknown. We recently treated an older patient with chronic kidney disease and severe hyperkalemia in whom non-convulsive status epilepticus developed following a correction of severe hyperkalemia. CASE PRESENTATION: An 82-year-old male was admitted to our hospital at midnight because of weakness of all four limbs (Day 1). He underwent urgent hemodialysis for severe hyperkalemia (9.84 mEq/L) and his serum potassium concentration decreased to 4.97 mEq/L. He regained full consciousness and his limb weakness improved on the morning of Day 2, but he became confused in the evening. Electroencephalogram revealed repeated low-voltage ictal discharges in the right occipital region and a diagnosis of non-convulsive status epilepticus was made. Following medication with fosphenytoin and phenytoin, the patient became fully alert and orientated on Day 8. CONCLUSION: We speculate that a rapid correction of hyperkalemia was the possible cause of non-convulsive status epilepticus development. To our knowledge, this is the first report of non-convulsive status epilepticus from a potassium abnormality. We described a case of this condition in detail and summarized 78 previous case reports of non-convulsive status epilepticus with kidney disease or electrolyte disturbances.
format Online
Article
Text
id pubmed-10084670
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-100846702023-04-11 Non-convulsive status epilepticus possibly induced by a rapid correction of severe hyperkalemia: a case report and literature review Bussaka, Saki Suehiro, Takaichi Mitsuiki, Koji Morioka, Takato Shono, Tadahisa Fujiki, Fujio Nakano, Toshiaki BMC Nephrol Case Report BACKGROUND: Patients with chronic kidney disease frequently develop neurological complications including confusion and altered consciousness. Non-convulsive status epilepticus, which is characterized by a change in behavior and/or mental process accompanied by epileptiform discharges on electroencephalogram in the absence of convulsive seizures, is one of the overlooked causes of altered consciousness. The incidence and precise pathophysiological mechanism of non-convulsive status epilepticus in patients with kidney disease, and especially in patients with electrolyte disturbances, remains unknown. We recently treated an older patient with chronic kidney disease and severe hyperkalemia in whom non-convulsive status epilepticus developed following a correction of severe hyperkalemia. CASE PRESENTATION: An 82-year-old male was admitted to our hospital at midnight because of weakness of all four limbs (Day 1). He underwent urgent hemodialysis for severe hyperkalemia (9.84 mEq/L) and his serum potassium concentration decreased to 4.97 mEq/L. He regained full consciousness and his limb weakness improved on the morning of Day 2, but he became confused in the evening. Electroencephalogram revealed repeated low-voltage ictal discharges in the right occipital region and a diagnosis of non-convulsive status epilepticus was made. Following medication with fosphenytoin and phenytoin, the patient became fully alert and orientated on Day 8. CONCLUSION: We speculate that a rapid correction of hyperkalemia was the possible cause of non-convulsive status epilepticus development. To our knowledge, this is the first report of non-convulsive status epilepticus from a potassium abnormality. We described a case of this condition in detail and summarized 78 previous case reports of non-convulsive status epilepticus with kidney disease or electrolyte disturbances. BioMed Central 2023-04-10 /pmc/articles/PMC10084670/ /pubmed/37038101 http://dx.doi.org/10.1186/s12882-023-03141-1 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Bussaka, Saki
Suehiro, Takaichi
Mitsuiki, Koji
Morioka, Takato
Shono, Tadahisa
Fujiki, Fujio
Nakano, Toshiaki
Non-convulsive status epilepticus possibly induced by a rapid correction of severe hyperkalemia: a case report and literature review
title Non-convulsive status epilepticus possibly induced by a rapid correction of severe hyperkalemia: a case report and literature review
title_full Non-convulsive status epilepticus possibly induced by a rapid correction of severe hyperkalemia: a case report and literature review
title_fullStr Non-convulsive status epilepticus possibly induced by a rapid correction of severe hyperkalemia: a case report and literature review
title_full_unstemmed Non-convulsive status epilepticus possibly induced by a rapid correction of severe hyperkalemia: a case report and literature review
title_short Non-convulsive status epilepticus possibly induced by a rapid correction of severe hyperkalemia: a case report and literature review
title_sort non-convulsive status epilepticus possibly induced by a rapid correction of severe hyperkalemia: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10084670/
https://www.ncbi.nlm.nih.gov/pubmed/37038101
http://dx.doi.org/10.1186/s12882-023-03141-1
work_keys_str_mv AT bussakasaki nonconvulsivestatusepilepticuspossiblyinducedbyarapidcorrectionofseverehyperkalemiaacasereportandliteraturereview
AT suehirotakaichi nonconvulsivestatusepilepticuspossiblyinducedbyarapidcorrectionofseverehyperkalemiaacasereportandliteraturereview
AT mitsuikikoji nonconvulsivestatusepilepticuspossiblyinducedbyarapidcorrectionofseverehyperkalemiaacasereportandliteraturereview
AT moriokatakato nonconvulsivestatusepilepticuspossiblyinducedbyarapidcorrectionofseverehyperkalemiaacasereportandliteraturereview
AT shonotadahisa nonconvulsivestatusepilepticuspossiblyinducedbyarapidcorrectionofseverehyperkalemiaacasereportandliteraturereview
AT fujikifujio nonconvulsivestatusepilepticuspossiblyinducedbyarapidcorrectionofseverehyperkalemiaacasereportandliteraturereview
AT nakanotoshiaki nonconvulsivestatusepilepticuspossiblyinducedbyarapidcorrectionofseverehyperkalemiaacasereportandliteraturereview