Oxcarbazepine
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Reactions 1390 - 25 Feb 2012 S Oxcarbazepine Exacerbation of perioral myoclonia with absences in a child: case report A boy [age not clearly stated], who was misdiagnosed with focal epilepsy, experienced exacerbation of perioral myoclonia with absences while receiving oxcarbazepine. The 10-year-old boy, who had a history of generalised convulsive seizures, presented with a clouded state associated with left hemifacial clonia, confusion and dysarthria. During the following year, his parents witnessed numerous short events. A neurological examination was subsequently performed, and oxcarbazepine [route and initial dosage not stated] was initiated for a diagnosis of focal cryptogenic epilepsy. Due to persistent seizures, his oxcarbazepine dosage was increased to 1500 mg twice daily. The seizures became longer in duration, with one progressing to a generalised tonic-clonic seizure [duration of treatment to reaction onset not stated]. At the age of 13 years, he was evaluated in an epilepsy centre. A polygraphic recording with EEG and electromyography was performed; interictal brief bursts of bilateral spike-waves and polyspike-waves were observed, occasionally predominating over the left or right hemisphere. He was usually unaware of the seizures, which varied in duration from 2-10 seconds. The predominant ictal symptom was rhythmic contraction of the perioral region. He appeared to pout, with protrusion and pursing of the lips, in addition to depression and lateral movement of the commissure. Myoclonia predominated on the left side, involving the mentalis, depressor anguli oris, and orbicularis oris muscles, and was often associated with neck myoclonia. Ictal EEG showed epileptiform discharges, which were irregular, fluctuated in amplitude, and occasionally fragmented. A diagnosis of perioral myoclonia with absences was suggested. Oxcarbazepine was replaced with levetiracetam. The boy’s seizures decreased a few months later and he had no further generalised tonic-clonic seizures. Prolonged perioral myoclonia of approximately 45 minutes duration persisted. Vrielynck P, et al. Perioral myoclonia with absences and myoclonic status aggravated by oxcarbazepine. Epileptic Disorders 13: 308-12, No. 3, Sep 2011 - Belgium 803067360 1 Reactions 25 Feb 2012 No. 1390 0114-9954/10/1390-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
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Transcript of Oxcarbazepine
Reactions 1390 - 25 Feb 2012
SOxcarbazepine
Exacerbation of perioral myoclonia withabsences in a child: case report
A boy [age not clearly stated], who was misdiagnosedwith focal epilepsy, experienced exacerbation of perioralmyoclonia with absences while receiving oxcarbazepine.
The 10-year-old boy, who had a history of generalisedconvulsive seizures, presented with a clouded stateassociated with left hemifacial clonia, confusion anddysarthria. During the following year, his parents witnessednumerous short events. A neurological examination wassubsequently performed, and oxcarbazepine [route andinitial dosage not stated] was initiated for a diagnosis offocal cryptogenic epilepsy. Due to persistent seizures, hisoxcarbazepine dosage was increased to 1500 mg twicedaily. The seizures became longer in duration, with oneprogressing to a generalised tonic-clonic seizure [durationof treatment to reaction onset not stated]. At the age of13 years, he was evaluated in an epilepsy centre. Apolygraphic recording with EEG and electromyography wasperformed; interictal brief bursts of bilateral spike-wavesand polyspike-waves were observed, occasionallypredominating over the left or right hemisphere. He wasusually unaware of the seizures, which varied in durationfrom 2-10 seconds. The predominant ictal symptom wasrhythmic contraction of the perioral region. He appeared topout, with protrusion and pursing of the lips, in addition todepression and lateral movement of the commissure.Myoclonia predominated on the left side, involving thementalis, depressor anguli oris, and orbicularis orismuscles, and was often associated with neck myoclonia.Ictal EEG showed epileptiform discharges, which wereirregular, fluctuated in amplitude, and occasionallyfragmented. A diagnosis of perioral myoclonia withabsences was suggested.
Oxcarbazepine was replaced with levetiracetam. Theboy’s seizures decreased a few months later and he had nofurther generalised tonic-clonic seizures. Prolongedperioral myoclonia of approximately 45 minutes durationpersisted.Vrielynck P, et al. Perioral myoclonia with absences and myoclonic statusaggravated by oxcarbazepine. Epileptic Disorders 13: 308-12, No. 3, Sep 2011 -Belgium 803067360
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Reactions 25 Feb 2012 No. 13900114-9954/10/1390-0001/$14.95 © 2010 Adis Data Information BV. All rights reserved
