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Persistent dysarthria after cefazolin-induced status epilepticus

Authors
Lee, YunaPyun, Sung-BomPark, Eun KyungYoun, Sung Won
Issue Date
2009
Publisher
TAYLOR & FRANCIS LTD
Keywords
Dysarthria; seizure; rehabilitation; drug use; cognition
Citation
BRAIN INJURY, v.23, no.10, pp 846 - 851
Pages
6
Indexed
SCIE
SCOPUS
Journal Title
BRAIN INJURY
Volume
23
Number
10
Start Page
846
End Page
851
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/120902
DOI
10.1080/02699050903196704
ISSN
0269-9052
1362-301X
Abstract
Background: Cefazolin is a well-known antibiotic associated with seizures. However, intrathecal cefazolin-induced status epilepticus (SE) is very rare and resultant persistent dysarthria has not been previously reported. Case report: A 66-year-old woman underwent epidural adhesiolysis due to lumbar spinal stenosis and 500 mg of cefazolin was infused through the thecal puncture site during the procedure. SE developed abruptly 40 minutes later and it persisted for 3 days. Severe dysarthria, dysphagia and cognitive dysfunction developed after the cessation of SE. Although the patient's other symptoms showed much improvement after rehabilitation, the dysarthria did not improve after intense speech therapy for 8 months. The brain MRI showed no abnormal findings, but the 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG PET) of the brain demonstrated hypometabolic areas in the bilateral inferior frontal gyrus and the primary motor cortex, representing the oromotor area. Conclusion: Although the exact mechanism underlying the dysarthria is unknown, the dysfunction of the inferior frontal network for speech production revealed by the brain FDG-PET, including the motor speech area (Broca's area), left insula and bilateral primary and premotor cortex representing the oromotor area, might have been responsible for the persistent dysarthria in this patient.
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