TREATMENT
Since an underlying cause of his seizures was not identified after
thorough work-up, treatment focused on controlling the patient’s BP with
medications and optimizing his volume status with dialysis continuing
ESRD treatments. There was concern that he may have been missing BP
medication doses at home resulting in large increases in BP and hence,
was advised to continue losartan, carvedilol, clonidine, and minoxidil
with the clonidine being in the form of a catapres patch. Given the
unknown etiology of seizures, although most likely from hypertensive
emergency and subsequent encephalopathy, the patient was discharged home
on levetiracetam to help prevent future seizures.