Reactions 482 - 18 Dec 1993

Carbamazepine

Facial motor tics: 3 case reportsThree boys, aged 5, 9 and 17 years, developed facial motor

tics during carbamazepine therapy for complex partialseizures. These patients had no previous history of involuntarymovement disorder or major neurological deficit.

Symptoms including repetitive blinking, jaw opening orclenching, and tongue movements, began 2–6 weeks aftercarbamazepine was initiated at a dose of 5–10 mg/kg/day. In all3 patients, the carbamazepine levels were in the therapeuticrange.

In the 9-year-old boy, the tics gradually improved over 4months during continued therapy, but worsened again whenthe carbamazepine dosage was increased from 5 to 7.5mg/kg/day. Carbamazepine was replaced with primidone andthe tics resolved completely. In the other 2 patients, the ticsresolved within several months during continuedcarbamazepine therapy at the same or a higher dosage.

Author comment: ‘Development of motor tics inassociation with CBZ [carbamazepine] therapy is uncommonand has been reported in only 4 children; in all, CBZ appearedto have precipitated or exacerbated an underlying Tourette’ssyndrome. The relatively mild and transient nature of CBZ-induced involuntary movements, even when CBZ is continued,suggests that if clinically warranted, it may be feasible tocontinue CBZ treatment.’Robertson PL, et al. Carbamazepine-induced tics. Epilepsia 34: 965-968, Sep-Oct1993 - USA 800224627

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Reactions 18 Dec 1993 No. 4820114-9954/10/0482-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved