Seizures associated with fluoroquinolones.

OBJECTIVE: To report two cases of seizures following administration of levofoxacin and ciprofloxacin. CASE SUMMARY: A 75-year-old white woman admitted to the hospital was prescribed levofloxacin for ischemic toes. After receiving three doses of oral levofloxacin, the patient experienced a seizure. One month later, the patient was rechallenged with ciprofloxacin and again experienced a seizure. The patient was hypomagnesemic and had elevated serum creatinine at the time of both seizures, and was hyponatremic during the second seizure. A 74-year-old white woman admitted to the hospital was prescribed levofloxacin for bacterial pneumonia. After five doses, the patient experienced a seizure. The woman had no electrolyte imbalances at the time of the seizure and no history of a seizure disorder. DISCUSSION: Quinolone antibiotics vary in their ability to induce seizures, with trovafloxacin having the greatest potential and levofloxacin possibly having the least potential. Neither patient had a history of a previous seizure disorder. Electrolyte imbalances are common with previous reports of fluoroquinolone-induced seizures. CONCLUSIONS: Although levofloxacin monotherapy has not been implicated in inducing seizures, it appears to be the causative agent in the second case. In the first case, the quinolones may have been a necessary, but not sufficient, cause in a patient with electrolyte abnormalities. Risk factors for fluoroquinolone-induced seizures may Include seizure history, electrolyte imbalances,dose unadjusted for renal insufficiency, and concomitant treatment with agents that lower the seizure threshold.

Authorial intentions and metaphor comprehension.

Three experiments investigated the role of authorial intentions in metaphor comprehension. In these studies, subjects read metaphoric (e.g., "A family album is like a museum"), literal (e.g., "An art gallery is like a museum"), and anomalous (e.g., "A tortoise shell is like an art gallery") comparisons and rated their degree of meaningfulness (Experiment 1), made speeded decisions as to whether each phrase was meaningful or not (Experiment 2), or wrote out interpretations of each comparison statement (Experiment 3). The subjects were told that the comparisons were written either by famous 20th century poets or by a computer program that randomly generated the statements from a list of words. Our general hypothesis was that knowing that intentional agents (the poets) authored the different comparisons should facilitate subjects' comprehension of the metaphors. Experiment 1 showed that subjects rated both metaphoric and literal comparisons as being more meaningful in the poet condition than when these statements were supposedly written by computer. Experiment 2 demonstrated that subjects were faster in making their meaningfulness judgments for metaphors in the poet condition than in the computer context, but that subjects were also slower in rejecting anomalous comparisons when these were supposedly written by the poets. Experiment 3 indicated that subjects produced more meanings or interpretations for comparisons presumably written by poets than by computer. These results highlight the importance of implied, authorial intentions in understanding metaphorical statements. We discuss the implications of this work for psycholinguistic theories of figurative language comprehension, as well as for theories of literary interpretation.