Vigabatrin/carbamazepine
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Reactions 462 - 31 Jul 1993 Vigabatrin/carbamazepine Encephalopathy: 2 case reports Two women developed acute encephalopathy after starting vigabatrin in addition to carbamazepine as treatment for seizures. The first woman, a 24-year-old with generalised tonic-clonic seizures resistant to standard therapy, became lethargic and confused and had several clonic jerks of her arms, 4 days after starting vigabatrin 1 g/day in addition to carbamazepine 1.8 g/day. After vigabatrin was increased to 1.5 and 2 g/day on days 6 and 7, respectively, the patient’s condition continued to deteriorate. Vigabatrin was discontinued on day 9 and the woman’s seizures resolved within 2 weeks. The second patient, a 14-year-old girl, had symptomatic focal epilepsy and mental retardation, resistant to standard treatment. She was given vigabatrin 2 g/day in addition to carbamazepine 2 g/day for 7 days, but this did not control her seizures. Vigabatrin was increased to 4 g/day, but the patient became stuporous and dysphoric. Vigabatrin was decreased to 3 g/day and she stabilised, but her focal seizures were not controlled. On increasing vigabatrin to 4 g/day, she became stuporous again, and mild, asymmetric myoclonic jerks were seen. The patient’s EEG background returned to her usual 6–7 Hz once vigabatrin was withdrawn. Author comment: ‘We do not know whether an interaction between carbamazepine and vigabatrin caused the acute encephalopathy. With vigabatrin monotherapy, encephalopathy has not been reported.’ S¨ alke-Kellermann A, et al. Acute encephalopathy with vigabatrin. Lancet 342: 185, 17 Jul 1993 - Germany 800208166 1 Reactions 31 Jul 1993 No. 462 0114-9954/10/0462-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Transcript of Vigabatrin/carbamazepine
Reactions 462 - 31 Jul 1993
Vigabatrin/carbamazepine
Encephalopathy: 2 case reportsTwo women developed acute encephalopathy after starting
vigabatrin in addition to carbamazepine as treatment forseizures.
The first woman, a 24-year-old with generalised tonic-clonicseizures resistant to standard therapy, became lethargic andconfused and had several clonic jerks of her arms, 4 days afterstarting vigabatrin 1 g/day in addition to carbamazepine1.8 g/day. After vigabatrin was increased to 1.5 and 2 g/day ondays 6 and 7, respectively, the patient’s condition continued todeteriorate. Vigabatrin was discontinued on day 9 and thewoman’s seizures resolved within 2 weeks.
The second patient, a 14-year-old girl, had symptomaticfocal epilepsy and mental retardation, resistant to standardtreatment. She was given vigabatrin 2 g/day in addition tocarbamazepine 2 g/day for 7 days, but this did not control herseizures. Vigabatrin was increased to 4 g/day, but the patientbecame stuporous and dysphoric. Vigabatrin was decreased to3 g/day and she stabilised, but her focal seizures were notcontrolled. On increasing vigabatrin to 4 g/day, she becamestuporous again, and mild, asymmetric myoclonic jerks wereseen. The patient’s EEG background returned to her usual 6–7Hz once vigabatrin was withdrawn.
Author comment: ‘We do not know whether an interactionbetween carbamazepine and vigabatrin caused the acuteencephalopathy. With vigabatrin monotherapy,encephalopathy has not been reported.’Salke-Kellermann A, et al. Acute encephalopathy with vigabatrin. Lancet 342: 185,17 Jul 1993 - Germany 800208166
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Reactions 31 Jul 1993 No. 4620114-9954/10/0462-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
