Table 1 Summary of patient characteristics, seizures, and outcome
From: Infliximab‐induced seizures in a patient with Crohn’s disease: a case report
Patients | Age at presentation,gender | Inflammatory disorder | TNF-alpha inhibitor onset to seizures | Features of seizures | EEG | CSF | Other | Treatment for the seizures | Seizures outcome | Inflammatory disorder outcome | Study author and year of publication |
|---|---|---|---|---|---|---|---|---|---|---|---|
1 | 14, male | Crohn’s disease | 5 days after the first infliximab administration | Repeated episodes each lasting about 1 min and followed by several periods of generalized tonic clonic seizures lasting more than 6 min | Mild excess slow wave activity | Normal | MRI revealed abnormal T2 and fluid-attenuated inversion recovery signal hyperintensities in a broadly symmetrical distribution affecting the cerebellar hemispheres, occipital poles, medial parietal lobes, and peripheral frontal lobes | TNF-alpha inhibitor stopped, phenytoin | No more seizures occurred | Remission for 6 months and finally relapse, culminating in colectomy and ileostomy. | Zamvar,2009[9] |
2 | 74, male | Crohn’s disease | 2 days after the second infliximab administration | Impairment of consciousness, amnesia and arrest of volitional movements, confusion and disorientation, aggressiveness | Focal paroxysmal activity | Not recorded | MRI showed encephalopathy involving mainly cortical regions | TNF-alpha inhibitor stopped | No more seizures occurred | Not recorded | Brigo,2011[10] |
3 | 24, female | Crohn’s disease | 3 days following the second infliximab infusion | Experienced 2 episodes of generalized tonic clonic seizures | Diffuse nonspecific cerebral dysfunction | Not recorded | MRI showed scattered T2/FLAIR signal abnormalities in the sub-cortical white matter predominantly in the frontal and posterior parietal lobes | TNF-alpha inhibitor stopped | No more seizures occurred | Not recorded | Chow,2016[12] |
4 | 8, female | Crohn’s disease | 13 days after the first infliximab infusion | Nausea, visual disturbance, unresponsive dilated reactive pupils, bradycardic and hypertensive. | Right temporal lobe dysfunction | Normal | MRI showed abnormal high signal in the subcortical region, bilateral occipital lobes, and on the right side with extension to involve the right temporal region | TNF-alpha inhibitor stopped, benzodiazepine, phenytoin | Three focal seizures post discharge | Well controlled, and no further seizures at two year follow up. | Haddock,2011[11] |