Generalized periodic discharges with triphasic morphology (GPDs + TWm) have been reported with multiple metabolic and drug toxicities. Beta-lactam antibiotics in some cases can cause neurotoxicity with GPDs + TWm on EEG. There are no reports in the literature of aztreonam causing neurotoxicity and GPDs + TWm. Here we describe GPDs + TWm and encephalopathy developing in a patient with underlying dementia and acute kidney injury who was started on aztreonam for cystitis. Neurotoxic effects of beta-lactam antibiotics have been well studied at this point, likely related to GABA receptor antagonism by the beta lactam ring. Risk factors for toxicity include, advanced age, prior neurological injury and decreased renal clearance. This patient carried multiple risk factors for beta-lactam neurotoxicity. Discontinuation of aztreonam led to a resolution of GPDs + TWm on EEG, and regression of encephalopathy.

中文翻译：

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氨曲南神经毒性背景下具有三相形态的广义周期性放电

据报道，具有三相形态 (GPDs + TWm) 的全身周期性放电具有多种代谢和药物毒性。在某些情况下，β-内酰胺抗生素会导致 EEG 上 GPDs + TWm 的神经毒性。文献中没有氨曲南引起神经毒性和 GPDs + TWm 的报道。在这里，我们描述了一名患有潜在痴呆和急性肾损伤的患者的 GPDs + TWm 和脑病，该患者开始使用氨曲南治疗膀胱炎。β-内酰胺抗生素的神经毒性作用在这一点上得到了很好的研究，可能与β-内酰胺环对 GABA 受体的拮抗作用有关。毒性的危险因素包括高龄、既往神经损伤和肾清除率降低。该患者具有多种 β-内酰胺神经毒性危险因素。