Carbamazepine
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Reactions 1420 - 22 Sep 2012 Carbamazepine Non-epileptic myoclonus and tic-like movements: case report A 31-year-old man developed non-epileptic myoclonus and tic-like movements while receiving carbamazepine for idiopathic generalised epilepsy. The man had started receiving carbamazepine 200 mg/day [route of administration not stated] soon after generalised tonic-clonic seizures began at 10 years of age. The carbamazepine dosage was increased to 800 mg/day three months later due to the recurrence of seizures. On observation at 31 years of age, he displayed involuntary movements, mainly in the right thumb and shoulders. His mother said the movements had emerged after carbamazepine initiation at age 10 years, and not resolved. Interictal EEG revealed multifocal and diffuse sharp waves. Video-polygraphic recording demonstrated repetitive rapid abduction of the right thumb associated with tic-like movements and a brief burst of rhythmic myoclonic jerks on the EMG tracing. Emotional stimuli increased the involuntary movements, and they were attenuated by sleep, and voluntary movements or posturing. A causative role of carbamazepine was suspected, and the drug was withdrawn within 15 days. Levetiracetam was administered. Within one week of carbamazepine discontinuation, the abnormal movements had resolved, and did not recur. After 3 months, carbamazepine 400 mg/day was reintroduced for 2 weeks which was followed by the re- emergence of involuntary movements. Carbamazepine was discontinued, and the movements resolved within a few days. Author comment: "[T]he reappearance of involuntary movements after the reintroduction of [carbamazepine] and the disappearance after [carbamazepine] withdrawal supported the causative role of [carbamazepine]". Magaudda A, et al. Carbamazepine-induced non-epileptic myoclonus and tic-like movements. Epileptic Disorders 14: 172-173, No. 2, Jun 2012. Available from: URL: http://dx.doi.org/10.1684/epd.2012.0504 - Italy 803077266 1 Reactions 22 Sep 2012 No. 1420 0114-9954/10/1420-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Carbamazepine
Reactions 1420 - 22 Sep 2012
Carbamazepine
Non-epileptic myoclonus and tic-like movements:case report
A 31-year-old man developed non-epileptic myoclonusand tic-like movements while receiving carbamazepine foridiopathic generalised epilepsy.
The man had started receiving carbamazepine 200mg/day [route of administration not stated] soon aftergeneralised tonic-clonic seizures began at 10 years of age.The carbamazepine dosage was increased to 800 mg/daythree months later due to the recurrence of seizures. Onobservation at 31 years of age, he displayed involuntarymovements, mainly in the right thumb and shoulders. Hismother said the movements had emerged aftercarbamazepine initiation at age 10 years, and not resolved.Interictal EEG revealed multifocal and diffuse sharp waves.Video-polygraphic recording demonstrated repetitive rapidabduction of the right thumb associated with tic-likemovements and a brief burst of rhythmic myoclonic jerkson the EMG tracing. Emotional stimuli increased theinvoluntary movements, and they were attenuated bysleep, and voluntary movements or posturing.
A causative role of carbamazepine was suspected, andthe drug was withdrawn within 15 days. Levetiracetam wasadministered. Within one week of carbamazepinediscontinuation, the abnormal movements had resolved,and did not recur.
After 3 months, carbamazepine 400 mg/day wasreintroduced for 2 weeks which was followed by the re-emergence of involuntary movements. Carbamazepine wasdiscontinued, and the movements resolved within a fewdays.
Author comment: "[T]he reappearance of involuntarymovements after the reintroduction of [carbamazepine] andthe disappearance after [carbamazepine] withdrawalsupported the causative role of [carbamazepine]".Magaudda A, et al. Carbamazepine-induced non-epileptic myoclonus and tic-likemovements. Epileptic Disorders 14: 172-173, No. 2, Jun 2012. Available from:URL: http://dx.doi.org/10.1684/epd.2012.0504 - Italy 803077266
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Reactions 22 Sep 2012 No. 14200114-9954/10/1420-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
