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Evaluation of Epileptic Seizures Developed During Hematopoietic Stem Cell Transplantation: A Single Center Experience
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Original Article
VOLUME: 54 ISSUE: 1
P: 40-50
2021

Evaluation of Epileptic Seizures Developed During Hematopoietic Stem Cell Transplantation: A Single Center Experience

Acta Haematol Oncol Turc 2021;54(1):40-50
DOI: 10.5505/aot.2021.57805
Serhat Çelik 1
Zeynep Tuğba Güven 1
Nimet Kübra Özsoy 2
Ayşe Günay 3
Muzaffer Keklik 1
Leylagül Kaynar 1
Bülent Eser 1
Mustafa Çetin 1
Ali Ünal 1
1. Department of Hematology, Erciyes University Faculty of Medicine, Kayseri, Turkey
2. Department of Internal Medicine, Erciyes University Faculty of Medicine, Kayseri, Turkey
3. Department of Clinical Pharmacy, Erciyes University Faculty of Pharmacy, Kayseri, Turkey
4.
No information available.
No information available
Received Date: 2020-05-04T12:21:51
Accepted Date: 2021-04-07T09:22:53
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Abstract

INTRODUCTION

Hematopoietic Stem Cell Transplant (HSCT) is one of the most effective treatment for hematological malignancies but has some complications. Epileptic seizures are consciousness, motor and sensory symptoms caused by temporary central nervous system dysfunction caused by recurrent abnormal neuronal discharges. Epileptic seizures are one of the complications of HKHN and affect its prognosis poorly. Our aim is to determine the causes and risk factors of epileptic seizures that develop during HSCT, thus preventing the development of seizures and positively affecting the prognosis of HSCT, which has a high complication rate.

METHODS

Twelve patients who had seizures while being hospitalized at Erciyes University Bone Marrow Transplantion Unit were included between October 2018 and October 2019. Patients diagnosed with subacute sclerosing panencephalitis were excluded.

RESULTS

Nine patients (75%) received ASCT and 3 patients (25%) received allo-HSCT. Epileptic seizures were observed in 8.2% of ASCTs and 5.4% of allo-HSCTs. None of the patients had hypoglycemia or hyponatremia. Eight patients (66.6%) had hypophosphatemia, 6 (50%) had hypokalemia, 4 (33.3%) had hypomagnesemia. The median number of drugs is 8 ± 2.1 (6-14). The median number of drugs that lower the seizure threshold is 5.5 ± 1.4 (4-8). Among the drugs that lower the epileptic threshold, fluconazole 75% (n=9), Meropenem 58.3% (n=7), Metronidazole 60% (n=6), Isoniazid 33.3% (n=4) were used most frequently. One (8.3%) of our patients had died.

DISCUSSION AND CONCLUSION

The reason for developing epileptic seizures is thought to be correlated with multiple factors that co-exist and interact with each other in a complicated clinical situation after HSCT. Polypharmacy, especially the use of drugs that lower the seizure threshold and electrolyte imbalances such as hypophosphatemia and hypokalemia were common in our patients with epileptic seizures. Therefore, close monitoring of these two factors is seen as the most important approach in preventing epileptic seizure development after HSCT.