Reactions 1438 - 9 Feb 2013

SOxcarbazepine

Status epilepticus induced by hyponatraemia: casereport

A 60-year-old woman developed status epilepticus inducedby hyponatraemia while receiving oxcarbazepine for a focalepilepsy.

The woman was admitted with repeated focal seizures withsecondary generalisation resembling cluster seizure activity.She had a history of surgery for right frontal cavernoma, afterwhich she developed a focal epilepsy with secondarygeneralised seizures. She was treated with levetiracetam andoxcarbazepine 900mg daily [route and duration of therapybefore reaction onset not stated]. Shortly after admission,status epilepticus occurred, which was refractory to treatment.

The woman was administered thiopental and valproic acidboluses followed by continuous infusions. Once the statusepilepticus had resolved, she was given valproic acid andlevetiracetam. She was continued on other medications –midazolam, mannitol, glucose, KCl and NaCl perfusions andB1 and B6 vitamins. Laboratory tests showed a low serumsodium level (125 mmol/L) and a low potassium level(2.3 mEq/L). An EEG demonstrated theta activity (5–6 c/sec) onright frontal derivations corresponding to the lesion site. Shewas diagnosed with status epilepticus, hyponatraemia andhypokalaemia. Once oxcarbazepine was discontinued, herclinical evolution was favourable, with no seizure activity. Shewas discharged after 10 days with normal electrolyte values.An EEG revealed an intermittent theta pattern in the frontaltemporal derivation. She continued on levetiracetam andvalproic acid, and was free of seizures.

Author comment: "The suggested etiology ofhyponatremia, which in our opinion caused and maintainedthe cluster seizures and later the status epilepticus could havebeen the oxcarbazepine therapy".Roman-Filip C, et al. Status epilepticus induced by hyponatremia as an adversereaction to oxcarbazepine - Case report. Revista Romana de Neurologie 11:199-202, No. 4, 2012 - Romania 803083005

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Reactions 9 Feb 2013 No. 14380114-9954/10/1438-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved