Myoclonic status epilepticus induced by cefepime overdose requiring haemodialysis

BMJ Case Rep. 2019 Jun 6;12(6):e228108. doi: 10.1136/bcr-2018-228108.


We report a case of cefepime neurotoxicity characterised by myoclonic status epilepticus with coma, in a context of acute renal failure and requiring one discontinuous conventional haemodialysis. Cefepime is a fourth-generation broad-spectrum cephalosporin mainly used to treat hospital-acquired Gram-negative infections. Acute neurotoxicity is an increasingly reported adverse effect which occurs predominantly in patients with renal impairment. Renal replacement therapy has been proposed to treat this condition.

Keywords: dialysis; epilepsy and seizures; healthcare improvement and patient safety; unwanted effects/adverse reactions.

Publication types

  • Case Reports

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / therapy*
  • Aged, 80 and over
  • Anti-Bacterial Agents / adverse effects*
  • Anti-Bacterial Agents / toxicity
  • Bronchiectasis / drug therapy
  • Cefepime / adverse effects*
  • Cefepime / toxicity
  • Drug-Related Side Effects and Adverse Reactions
  • Epilepsies, Myoclonic / chemically induced*
  • Epilepsies, Myoclonic / physiopathology
  • Fatal Outcome
  • Female
  • Humans
  • Neurotoxicity Syndromes / complications
  • Neurotoxicity Syndromes / diagnosis
  • Renal Dialysis
  • Status Epilepticus / chemically induced*
  • Status Epilepticus / physiopathology


  • Anti-Bacterial Agents
  • Cefepime