Korean J Anesthesiol.  2013 Sep;65(3):262-265. 10.4097/kjae.2013.65.3.262.

Sudden severe hyperammonemia and status epilepticus: a case report

• Shin WK
• Jang YE
• Lee H
• Min SH
• Ryu HG

• KMID: 2239728
• DOI: http://doi.org/10.4097/kjae.2013.65.3.262

Abstract

There are various causes to a low level of consciousness in patients in the intensive care unit. Neurological injury, infection, and metabolic disarray are considered as some of the causes. A 39 year-old female patient was transferred to our hospital with septic shock due to ascending colon perforation. The patient had previously received ovarian cancer surgery and a cycle of chemotherapy at another hospital. Emergent operation for colon perforation was successful. After the operation, she was treated in the intensive care unit for infectious and pulmonary complications. She suddenly showed deterioration in her level of consciousness and had a generalized seizure. At the time of her seizure, she had severe hyperammonemia. Brain CT showed severe cerebral edema that was absent in the CT scan taken 2 days before. Continuous renal replacement therapy was conducted but was ineffective in lowering the level of serum ammonia and the patient subsequently died.

Keyword

Hyperammonemia; Seizures; Status epilepticus

MeSH Terms

Ammonia
Brain
Brain Edema
Colon
Colon, Ascending
Consciousness
Female
Humans
Hyperammonemia
Intensive Care Units
Ovarian Neoplasms
Renal Replacement Therapy
Seizures
Shock, Septic
Status Epilepticus
Ammonia