You are here

Article Text

Article menu
Download PDFPDF
Case Reports: Learning from unexpected outcome (positive or negative)
Increased seizure frequency in an epilepsy patient receiving medium cut-off dialysis
  1. Maria Lean1,
  2. Stephen May2,
  3. Michael McLucas2 and
  4. Malcolm Green2
  1. 1Department of Medicine, John Hunter Hospital, New Lambton Heights, New South Wales, Australia
  2. 2Department of Medicine, Tamworth Rural Referral Hospital, Tamworth, New South Wales, Australia
  1. Correspondence to Dr Malcolm Green; malcolm.green{at}health.nsw.gov.au

Abstract

This paper presents the case of a male dialysis patient, with generalised epilepsy, who experienced complications after starting medium cut-off (MCO) dialysis. While receiving haemodiafiltration, the patient’s epilepsy had been relatively well controlled using two antiseizure medications (brivaracetam and sodium valproate). However, the patient’s seizure frequency increased when he was changed to MCO dialysis. MCO is a new dialysis method that has been developed to allow for better clearance of uraemic toxins through its larger pore size. We hypothesise that using the highly permeable MCO membrane changed the seizure threshold by an unknown mechanism. This is the first reported case to observe increased seizure frequency in a patient receiving MCO dialysis. The case highlights the need for caution when prescribing dialysis methods to patients with epilepsy.

  • Dialysis
  • Epilepsy and seizures
  • Pharmacokinetics

https://doi.org/10.1136/bcr-2022-250911

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors ML: writing and revising the manuscript, collecting and analysing data. Responsible for main design of the work. Reviewing literature. Revising the work. Final approval of the work. SM: planning and designing the work, interpretation of data, revising the work critically for intellectual content. Final approval of the work. MM: collecting data, drafting part of the manuscript, revising the work. Discussing the conception and design of the work. Final approval of the work. MG: critical analysis and revising of the manuscript. Final approval of the work. Correspondence author.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.