Isoniazid
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Status epilepticus: case report A 26-year-old man developed status epilepticus while receiving an antituberculosis regimen that included isoniazid. The man, who started receiving alternate-day treatment with isoniazid 600mg approximately 5 months earlier, was taken to an emergency room after developing seizures at home. The man’s seizures were terminated with diazepam, but recurred 2–3 minutes later. Treatment with lorazepam and phenytoin failed to control his seizures for the next 2 hours. Given his isoniazid consumption, pyridoxine was then administered, and his seizures resolved 90 minutes later. Laboratory results showed the following: sodium 140 mEq/L, potassium 4.0 mEq/L, chloride 112 mEq/L and blood sugar 140 mg/dL. No apparent pathological factors that could lead to seizures were evident on brain CT. After he regained consciousness, he reported that he had no history of epilepsy, and that he was taking isoniazid at the recommended dose. Isoniazid was restarted 3 days later; however, the man’s status epilepticus recurred after the second dose. Seizures were controlled with pyridoxine and other anticonvulsants. Isoniazid was subsequently removed from his regimen, and seizures had not recurred during 6 months of follow-up. Author comment: "Pyridoxine deficiency should be suspected and its supplementation initiated in any patient on antituberculous treatment presenting with seizures and metabolic acidosis even if there is no history of overdose." Aleemuddin NM. Acute neurotoxicity with appropriate dose of isoniazid: A case report. Indian Journal of Public Health Research and Development 2: 133-134, No. 803060388 1, Jan-Jun 2011 - India
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Reactions 24 Sep 2011 No. 1370
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