Carbamazepine
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Reactions 1091 - 4 Mar 2006 S Carbamazepine Nonconvulsive status epilepticus: 2 case reports Two female patents, aged 14 and 23 years, respectively, developed nonconvulsive status epilepticus during treatment with carbamazepine for seizures. Patient 1, who had a history of dissociative disorder, started receiving carbamazepine [dosage not stated] at 12 years of age following a generalised seizure. No further seizures occurred, but frequency of dissociative episodes steadily increased, and she was hospitalised. During admission, a typical episode was observed; she looked confused and apathetic, but could perform simple motor tasks with strong encouragement. She had facial blankness with occasional rhythmic jerking of the corner of her mouth. Almost continuous 3–4Hz generalised polyspike-and-wave discharges were observed on EEG. She received clobazam, with recovery of normal background activity. Carbamazepine was substituted for valproic acid and, over the next several months, her dissociative episodes did not recur. Patient 2, who had a history of depressive episodes and facial tics, started receiving carbamazepine 400 mg/day at 16 years of age following a tonic-clonic seizure. Seizures did not recur, but she experienced worsening episodes of apathetic behaviour associated with a facial tic after carbamazepine treatment; the episodes tended to cluster prior to menstruation. At 17 years of age, she was hospitalised during a typical episode, and continuous generalised 2Hz spike-and-polyspike-wave discharges were observed on EEG; electromyography showed facial and upper-limb myoclonic jerks, coinciding with the EEG spikes. She had fluctuating awareness. She received oral diazepam, with progressive resolution of myoclonic jerks and EEG activity; full awareness returned. Carbamazepine was substituted for valproic acid, with complete symptomatic remission. Author comment: "Both patients significantly worsened after starting carbamazepine treatment." Marini C, et al. Nonconvulsive status epilepticus precipitated by carbamazepine presenting as dissociative and affective disorders in adolescents. Journal of Child Neurology 20: 693-696, No. 8, Aug 2005 - Italy 801032909 1 Reactions 4 Mar 2006 No. 1091 0114-9954/10/1091-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 1091 - 4 Mar 2006
SCarbamazepine
Nonconvulsive status epilepticus: 2 case reportsTwo female patents, aged 14 and 23 years, respectively,
developed nonconvulsive status epilepticus during treatmentwith carbamazepine for seizures.
Patient 1, who had a history of dissociative disorder, startedreceiving carbamazepine [dosage not stated] at 12 years of agefollowing a generalised seizure. No further seizures occurred,but frequency of dissociative episodes steadily increased, andshe was hospitalised. During admission, a typical episode wasobserved; she looked confused and apathetic, but couldperform simple motor tasks with strong encouragement. Shehad facial blankness with occasional rhythmic jerking of thecorner of her mouth. Almost continuous 3–4Hz generalisedpolyspike-and-wave discharges were observed on EEG. Shereceived clobazam, with recovery of normal backgroundactivity. Carbamazepine was substituted for valproic acid and,over the next several months, her dissociative episodes did notrecur.
Patient 2, who had a history of depressive episodes andfacial tics, started receiving carbamazepine 400 mg/day at16 years of age following a tonic-clonic seizure. Seizures didnot recur, but she experienced worsening episodes ofapathetic behaviour associated with a facial tic aftercarbamazepine treatment; the episodes tended to cluster priorto menstruation. At 17 years of age, she was hospitalisedduring a typical episode, and continuous generalised 2Hzspike-and-polyspike-wave discharges were observed on EEG;electromyography showed facial and upper-limb myoclonicjerks, coinciding with the EEG spikes. She had fluctuatingawareness. She received oral diazepam, with progressiveresolution of myoclonic jerks and EEG activity; full awarenessreturned. Carbamazepine was substituted for valproic acid,with complete symptomatic remission.
Author comment: "Both patients significantly worsenedafter starting carbamazepine treatment."Marini C, et al. Nonconvulsive status epilepticus precipitated by carbamazepinepresenting as dissociative and affective disorders in adolescents. Journal of ChildNeurology 20: 693-696, No. 8, Aug 2005 - Italy 801032909
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Reactions 4 Mar 2006 No. 10910114-9954/10/1091-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
