Background
Neurotoxicity refers to the ability to induce adverse effects in the
central nervous system (CNS), peripheral nerves, or sensory
organs.1 Neurological adverse events induced by
beta-lactams were first described in 1945 after the intraventricular
administration of penicillin G.5 Drug induced
neurotoxicity carries a wide spectrum of clinical manifestations ranging
from confusion, encephalopathy and hallucinations to myoclonus,
convulsions and non-convulsive status epilepticus which can be life
threatening.1 Encephalopathy is a type of
neurotoxicity that is defined as “a diffuse disease of the brain that
alters brain function or structure and is characterized by an altered
mental state with additional symptoms including progressive loss of
memory and cognitive ability, personality changes, myoclonus, nystagmus,
tremor, and seizures”.2
In recent years, beta-lactams adverse effects on the CNS have become
more widely recognized. Overexposure and high plasma concentrations of
these antibiotics due to unadjusted dosing in renally impaired patients
have been frequently implicated in neurological side
effects.6,7 We report a patient with normal renal
function who developed beta-lactam induced encephalopathy requiring ICU
admission with complete recovery of her symptoms after discontinuing the
causative drug.