Carbamazepine

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Carbamazepine Downbeat nystagmus Three weeks after starting carbamazepine, a 23-year-old woman developed episodes of vertigo, ataxia, nausea, vomiting, and vertical oscillopsia which occurred soon aftl."r taking the drug and cleared within 2- 3 hours. She was on concurrent propranolol for migraine. Neurological examination 2 hours after the onset of symptoms disclosed downbeat nystagmus which cleared within I hour. All medications were stopped. CT scan was normal as were CSF studies and X-rays of the cervical spine. Subsequent metrizamide cisternography accompanied by CT scan with Smm sections were also normal. A subsequent rechallenge with carbamazepine alone produced symptoms of primary position downbeat nystagmus, limb dysmetria and truncal ataxia 2 hours after taking carbamazepine on the second day. At the onset of symptoms the patient's free carbamazepine was 2.6 J"gj mt. Wht"; " .. kr. S.D. (' I al.: Annals or N eu ro!ogy 12: 117 I I 4 Reactions 26 Nov 1982 0157-7271 / 82/1126-0004 / 0$01.00 / 0 © ADISPress

Transcript of Carbamazepine

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Carbamazepine

Downbeat nystagmus Three weeks after starting carbamazepine, a 23-year-old woman developed episodes of vertigo, ataxia, nausea, vomiting, and vertical oscillopsia which occurred soon aftl."r taking the drug and cleared within 2-3 hours. She was on concurrent propranolol for migraine. Neurological examination 2 hours after the onset of symptoms disclosed downbeat nystagmus which cleared within I hour. All medications were stopped. CT scan was normal as were CSF studies and X-rays of the cervical spine. Subsequent metrizamide cisternography accompanied by CT scan with Smm sections were also normal. A subsequent rechallenge with carbamazepine alone produced symptoms of primary position downbeat nystagmus, limb dysmetria and truncal ataxia 2 hours after taking carbamazepine on the second day. At the onset of symptoms the patient's free carbamazepine was 2.6 J"gj mt. Wht";" .. kr. S.D. (' I al.: Annals or N euro!ogy 12: 117 ( ·\u~. I ')~! I

4 Reactions 26 Nov 1982 0157-7271 / 82/1126-0004/ 0$01.00/ 0 © ADISPress