{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T10:40:19Z","timestamp":1756291219245,"version":"3.44.0"},"reference-count":21,"publisher":"BMJ","issue":"4","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,2,22]]},"published-print":{"date-parts":[[2021,4]]},"abstract":"<jats:p>An 86-year-old woman was diagnosed with hospital-acquired pneumonia with <jats:italic>Pseudomonas aeruginosa<\/jats:italic> and treated with cefepime adjusted to her renal clearance. After 4\u2009days, she developed acute-onset negative myoclonus without signs of altered mental status. After ruling out an acute intracranial haemorrhagic or ischaemic stroke as well as other metabolic and endocrine causes of negative myoclonus, the antibiotic was switched to piperacillin\/tazobactam due to a suspicion of cefepime neurotoxicity. The patient improved within 24 hours and her symptoms fully resolved within 4\u2009days. These observations suggest a link of the negative myoclonus to acute cefepime neurotoxicity, which may occur without or with minimal alteration of mental status, thus extending its spectrum of clinical presentation.<\/jats:p>","DOI":"10.1136\/bcr-2020-239744","type":"journal-article","created":{"date-parts":[[2021,4,8]],"date-time":"2021-04-08T12:38:19Z","timestamp":1617885499000},"page":"e239744","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Negative myoclonus as the leading symptom in acute cefepime neurotoxicity"],"prefix":"10.1136","volume":"14","author":[{"given":"Philipp","family":"Zimmermann","sequence":"first","affiliation":[{"name":"Internal Medicine, Kantonsspital Baden, Baden, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Camenzind","sequence":"additional","affiliation":[{"name":"Internal Medicine, Kantonsspital Baden, Baden, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J\u00fcrg Hans","family":"Beer","sequence":"additional","affiliation":[{"name":"Internal Medicine, Kantonsspital Baden, Baden, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6984-6958","authenticated-orcid":false,"given":"Alexander Andrea","family":"Tarnutzer","sequence":"additional","affiliation":[{"name":"Neurology, Kantonsspital Baden, Baden, Switzerland"},{"name":"University of Zurich Faculty of Medicine, Z\u00fcrich, Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,4,8]]},"reference":[{"key":"2025082703115242000_14.4.e239744.1","doi-asserted-by":"crossref","first-page":"1931","DOI":"10.1002\/ccr3.1217","article-title":"Cefepime-induced neurotoxicity in a pediatric patient on chronic hemodialysis: a case report","volume":"5","author":"Guzman-Limon","year":"2017","journal-title":"Clin Case Rep"},{"key":"2025082703115242000_14.4.e239744.2","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2017-223954","article-title":"Cefepime-induced encephalopathy","volume":"72","author":"Kenzaka","year":"2018","journal-title":"BMJ Case Rep"},{"key":"2025082703115242000_14.4.e239744.3","first-page":"199","article-title":"Cefepime-Induced neurotoxicity despite dose adjustment for renal disease: a brief report and review of the literature","volume":"6","author":"Lindsay","year":"2017","journal-title":"J Pediatric Infect Dis Soc"},{"key":"2025082703115242000_14.4.e239744.4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1046\/j.1528-1157.44.s11.3.x","article-title":"Clinical presentations and phenomenology of myoclonus","volume":"44 Suppl 11","author":"Faught","year":"2003","journal-title":"Epilepsia"},{"key":"2025082703115242000_14.4.e239744.5","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1002\/mds.27121","article-title":"Consensus statement on the classification of tremors. from the task force on tremor of the International Parkinson and movement disorder Society","volume":"33","author":"Bhatia","year":"2018","journal-title":"Mov Disord"},{"key":"2025082703115242000_14.4.e239744.6","unstructured":"Koenitz A . 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