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Previous studies found that seizures in orthotopic liver transplantation (OLT)herald a catastrophic neurologic event,but the studies were done of the patients who later died and came to autopsy.We studies 630 OLT patients.Laboratory values,electroencephalography,neuroimaging,and levels of cyclosporine or FK506 were reviewed.Neurotoxicity from immunosuppression was considered a trigger for seizures when toxic blood level or increases>100%were documented,or when white matter lesions or confusion state or tremors were present.We conclude that the majority of new-onset seizures after OLT are not indicative of a poor prognosis. Immunosuppression neurotoxicity is the most frequent cause.Anticonvulsant therapy is not necessary for favorable long-term outcome. |
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