Penicillin-Induced Seizures during Cardiopulmonary Bypass

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Abstract
Penicillin, when administered intravenously in massive doses (50,000,000 units) during cardiopulmonary bypass, induced generalized seizures, evident clinically and electroencephalographically in four patients. Experiments in dogs showed that seven out of eight animals receiving high doses of penicillin intravenously during full cardiopulmonary bypass had epileptic seizures, whereas neither the bypass alone nor large amounts of penicillin given intravenously alone produced this neurologic complication. Our electroencephalographic data, as well as the clinical and experimental studies, suggest that these seizures result from penetration of penicillin into the brain through a blood–brain barrier rendered abnormally permeable by factors not yet clearly determined.