A Review of the Association between Infections, Seizures, and Drugs.

Zahra Tolou-Ghamari
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Abstract

Background: Seizures are a common presenting symptom of the central nervous system (CNS) and could occur from infections (such as toxins) or drugs.

Objective: The aim of this study was to present a systematic review of the association between infections, seizures, and drugs.

Methods: Through February 18, 2024, according to the PRISMA guidelines and based on the PICO standard format, relevant, in-depth consequent guide approach and evidence-based options were selected associated with a knowledgeable collection of current, high-quality manuscripts.

Results: Imbalance between inhibitory and excitatory neurotransmitters due to infections, drugs such as ticarcillin, amoxicillin, oxacillin, penicillin G, ampicillin, tramadol, venlafaxine, cyclosporine, tacrolimus, acyclovir, cellcept, the old generation of antiepileptic drugs, such as carbamazepine, phenytoin, and many other drugs could cause different stages of CNS disturbances ranging from seizure to encephalopathy. Infections could cause life-threatening status epilepticus by continuous unremitting seizures lasting longer than 5 minutes or recurrent seizures. Meningitis, tuberculosis, herpes simplex, cerebral toxoplasmosis, and many others could lead to status epilepticus. In fact, confusion, encephalopathy, and myoclonus were reported with drugs, such as ticarcillin, amoxicillin, oxacillin, penicillin G, ampicillin, and others. Penicillin G was reported as having the greatest epileptogenic potential. A high dose, in addition to prolonged use of metronidazole, was reported with seizure infection. Meropenem could decrease the concentration of valproic acid. Due to the inhibition of cytochrome P450 3A4, the combination of clarithromycin and erythromycin with carbamazepine needs vigilant monitoring.

Conclusion: Due to changes in drug metabolism, co-administration of antiseizure drugs and antibiotics may lead to an enhanced risk of seizures. In patients with neurocysticercosis, cerebral malaria, viral encephalitis, bacterial meningitis, tuberculosis, and human immunodeficiency virus, the evidence-based study recommended different mechanisms mediating epileptogenic properties of toxins and drugs.

感染、癫痫发作和药物之间的关联回顾。
背景:癫痫发作是中枢神经系统(CNS)的常见症状,可能由感染(如毒素)或药物引起:本研究旨在对感染、癫痫发作和药物之间的关系进行系统回顾:截至 2024 年 2 月 18 日,根据 PRISMA 指南和 PICO 标准格式,选择了相关的、深入的后续指导方法和基于证据的选项,并收集了当前高质量手稿的相关知识:感染、替卡西林、阿莫西林、奥沙西林、青霉素 G、氨苄西林、曲马多、文拉法辛、环孢素、他克莫司、阿昔洛韦、赛可啶等药物、卡马西平、苯妥英等老一代抗癫痫药物以及许多其他药物导致的抑制性和兴奋性神经递质失衡可引起从癫痫发作到脑病的不同阶段的中枢神经系统紊乱。感染可导致持续不间断的癫痫发作,持续时间超过 5 分钟,或反复发作,危及生命。脑膜炎、肺结核、单纯疱疹、脑弓形虫病和许多其他疾病都可能导致癫痫状态。事实上,有报告称替卡西林、阿莫西林、奥沙西林、青霉素 G、氨苄西林等药物可导致意识模糊、脑病和肌阵挛。据报道,青霉素 G 的致痫可能性最大。有报告称,除了长期使用甲硝唑外,大剂量也会导致癫痫感染。美罗培南可降低丙戊酸的浓度。由于细胞色素 P450 3A4 的抑制作用,克拉霉素和红霉素与卡马西平合用时需要警惕监测:结论:由于药物代谢的变化,抗癫痫药物和抗生素联合用药可能会增加癫痫发作的风险。在神经囊虫病、脑疟疾、病毒性脑炎、细菌性脑膜炎、结核病和人类免疫缺陷病毒患者中,循证研究建议毒素和药物具有不同的致痫机制。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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