Carbamazepine
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Reactions 1305 - 12 Jun 2010 S Carbamazepine Seizures secondary to hyponatraemia in an elderly patient: case report A 74-year-old man developed seizures secondary to hyponatraemia after starting carbamazepine following an initial seizure episode. Following admission for aphasia and right hemiparesis, a brain CT revealed an acute ischaemia lesion in the man’s temporal lobe. Around 36 hours postadmission, he experienced a generalised seizure. An EEG showed aspecific left hemisphere abnormalities and carbamazepine 100mg twice daily was started. Concomitant medications included atorvastatin, clopidogrel, esomeprazole and ramipril. Although his presenting symptoms had greatly improved 10 days postadmission, he had episodes of drowsiness, gait instability, slurred speech, absences and urine loss. Laboratory testing revealed mild hyponatraemia (124 mEq/L). During post-stroke rehabilitation, he experienced seizures at an increasing frequency [duration of therapy before reaction not stated] and his carbamazepine dosage was increased to 200mg twice daily, without benefit. A repeat EEG showed diffuse slowing discharges with no evident epileptic signs, while repeat testing revealed a sodium level of 117 mEq/L. Carbamazepine was discontinued and the man’s hyponatraemia resolved. Thereafter, he received no further antiepileptic medication and had no more seizures. Author comment: "[C]arbamazepine can paradoxically induce seizure by worsening hyponatremia". Maiorana E, et al. Carbamazepine-Induced Seizures. 2010 Annual Scientific Meeting of the American Geriatrics Society : abstr. A3, 12 May 2010. Available from: URL: http://www.americangeriatrics.org/annual%5fmeeting/ [abstract] - Italy 803019499 1 Reactions 12 Jun 2010 No. 1305 0114-9954/10/1305-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
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Transcript of Carbamazepine
Reactions 1305 - 12 Jun 2010
SCarbamazepine
Seizures secondary to hyponatraemia in anelderly patient: case report
A 74-year-old man developed seizures secondary tohyponatraemia after starting carbamazepine following aninitial seizure episode.
Following admission for aphasia and right hemiparesis, abrain CT revealed an acute ischaemia lesion in the man’stemporal lobe. Around 36 hours postadmission, heexperienced a generalised seizure. An EEG showedaspecific left hemisphere abnormalities and carbamazepine100mg twice daily was started. Concomitant medicationsincluded atorvastatin, clopidogrel, esomeprazole andramipril. Although his presenting symptoms had greatlyimproved 10 days postadmission, he had episodes ofdrowsiness, gait instability, slurred speech, absences andurine loss. Laboratory testing revealed mild hyponatraemia(124 mEq/L). During post-stroke rehabilitation, heexperienced seizures at an increasing frequency [durationof therapy before reaction not stated] and hiscarbamazepine dosage was increased to 200mg twicedaily, without benefit. A repeat EEG showed diffuse slowingdischarges with no evident epileptic signs, while repeattesting revealed a sodium level of 117 mEq/L.
Carbamazepine was discontinued and the man’shyponatraemia resolved. Thereafter, he received no furtherantiepileptic medication and had no more seizures.
Author comment: "[C]arbamazepine can paradoxicallyinduce seizure by worsening hyponatremia".Maiorana E, et al. Carbamazepine-Induced Seizures. 2010 Annual ScientificMeeting of the American Geriatrics Society : abstr. A3, 12 May 2010. Availablefrom: URL: http://www.americangeriatrics.org/annual%5fmeeting/ [abstract] -Italy 803019499
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Reactions 12 Jun 2010 No. 13050114-9954/10/1305-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
