A six-year-old child is admitted to the Paediatric ICU for seizures. He has been on treatment with Tacrolimus and Prednisolone. On investigations his blood urea is 68 mg/dl, Serum Sodium is 136 meq/l likely cause of his seizures –
Tacrolimus neurotoxicity is an established cause for 'seizures' and the most likely reason for seizures in this child.
In hyponatremia, seizures usually develop when sodium levels decrease below 125 meq/L.
In hypocalcaemia, seizures develop when calcium level is below 6 mg/dl.
Uremic seizures occur late after delirium, hallucinations and agitation.
Uremia
Hyponatremia
Hypocalcemia
Tacrolimus Toxity