Causes and outcome of seizures in liver transplant recipients

Eelco F M Wijdicks, David J. Plevak, Russel H. Wiesner, Jefferey L. Steers

Research output: Contribution to journalArticle

69 Citations (Scopus)

Abstract

Previous studies found that seizures in orthotopic liver transplantation (OLT) herald a catastrophic neurologic event, but the studies were done of patients who later died and came to autopsy. We studied 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 confusional state or tremors were present. Generalized tonic-clonic seizures occurred in 28 of 630 patients (4%). In 7 patients seizures were part of an agonal event (central nervous system infection [n = 3], anoxic encephalopathy [n = 1], cerebral edema with fulminant hepatic failure [n = 1], intracranial hemorrhage [n = 1], and sepsis [n = 1]). In 17 patients cyclosporine (n = 11) or FK506 (n = 6) could be implicated. Remaining causes were acute uremia (n = 1), meningioma (n = 1), and unknown (n = 2). All patients were initially treated with anticonvulsants. Median follow-up of 2 years did not reveal seizure recurrence after discontinuation of anticonvulsants. 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.

Original languageEnglish (US)
Pages (from-to)1523-1525
Number of pages3
JournalNeurology
Volume47
Issue number6
StatePublished - Dec 1996

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Seizures
Liver
Liver Transplantation
Anticonvulsants
Tacrolimus
Immunosuppression
Cyclosporine
Brain Hypoxia
Central Nervous System Infections
Confusion
Hepatic Encephalopathy
Intracranial Hemorrhages
Uremia
Poisons
Meningioma
Tremor
Neuroimaging
Nervous System
Transplant Recipients
Electroencephalography

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Wijdicks, E. F. M., Plevak, D. J., Wiesner, R. H., & Steers, J. L. (1996). Causes and outcome of seizures in liver transplant recipients. Neurology, 47(6), 1523-1525.

Causes and outcome of seizures in liver transplant recipients. / Wijdicks, Eelco F M; Plevak, David J.; Wiesner, Russel H.; Steers, Jefferey L.

In: Neurology, Vol. 47, No. 6, 12.1996, p. 1523-1525.

Research output: Contribution to journalArticle

Wijdicks, EFM, Plevak, DJ, Wiesner, RH & Steers, JL 1996, 'Causes and outcome of seizures in liver transplant recipients', Neurology, vol. 47, no. 6, pp. 1523-1525.
Wijdicks EFM, Plevak DJ, Wiesner RH, Steers JL. Causes and outcome of seizures in liver transplant recipients. Neurology. 1996 Dec;47(6):1523-1525.
Wijdicks, Eelco F M ; Plevak, David J. ; Wiesner, Russel H. ; Steers, Jefferey L. / Causes and outcome of seizures in liver transplant recipients. In: Neurology. 1996 ; Vol. 47, No. 6. pp. 1523-1525.
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