Status Epilepticus Secondary to Hyperammonemia (P5.082)

TL;DRAbstract

OBJECTIVE: We aim to highlight hyperammonemia as an unusual cause of status epilepticus. BACKGROUND: Elevated ammonia is implicated in pathogenesis of encephalopathy related to both hepatic and non-hepatic causes. The occurrence of seizures is a poorly understood manifestation of hyperammonemia and status epilepticus is extremely rare occurrence. DESIGN/METHODS: Case series review RESULTS: Case 1 was 63 years old when he presented with hyperammonemia (peak 493 µmol/L) due to fulminant hepatic failure who developed refractory status epilepticus requiring multiple AEDs and pentobarbital coma. His EEG showed generalized/bilateral periodic epileptiform discharges (GPEDs/biPLEDs) and left>right independent electrographic seizures. His brain MRI showed restricted diffusion of the cortical gray matter on diffusion-weighted imaging (DWI) sequences, predominantly involving cingulate and insular cortex while sparing peri-rolandic cortex and white matter. Case 2 was a 53 year-old female who devel

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