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We studied causes of new-onset seizures in 55 patients admitted to medical and surgical intensive care units between 1981 and 1991.In one-third of the patients,sudden withdrawal of narcotic agents was associated with tonic-clonic seizures.In another third,acute metabolic changes, predominantly severe hyponatremia(sodium-125 mEq/l),accounted for new- onset seizures.In eight patients,drug toxicity(antibiotics and antiarrhythmic agents)predisposed to seizures.Only five patients had previously unrecognized structural CNS abnormalities that were manifested by focal or generalized tonic-clonic seizures.In six patients,the cause remained unknown.Twenty-four patients had recurrent seizures despite treatment with standard antiepileptic drugs.Status epilepticus occurred in four months.Outcome was poor in only 34%of the patients,particularly in those with metabolic causes.Sudden withdrawal of narcotic drugs may be a significant cause of new-onset seizures in patients with life-threatening disorders. |
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adverse drug reaction antibiotics antibiotics,neurologic complications with critical care unit encephalopathy,metabolic hyponatremia narcotic analgesics neurologic complications of,systemic disease seizure seizure,drug-induced seizure,etiology of seizure,focal seizure,prognosis in adults seizure,risk factors for seizure,tonic-clonic seizure,withdrawal status epilepticus
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