Reactions 1131 - 9 Dec 2006

O SCarbamazepine overdose

Seizures, coma and respiratory insufficiency in achild: case report

An overdose of carbamazepine in a 2-year-old boy resultedin seizures, coma and respiratory insufficiency, but he wassuccessfully treated with continuous venovenoushaemodiafiltration (CVVHDF).

The boy was hospitalised 20 hours after ingesting five of hisgrandmother’s controlled-release carbamazepine [Tegretol-CR] 400mg tablets (total dose 2g). He had experienced ageneralised tonic-clonic seizure before admission. Onadmission, he was unconscious and his serum carbamazepineconcentration was > 20 µg/mL; he also had leucopenia andneutropenia.

The boy was treated with bowel irrigation and gastric lavagewith oral activated charcoal. After 2 hours, his pupils becamenonreactive and midriatic, he had a 1-minute generalisedtonic-clonic seizure and developed respiratory arrest. He wasintubated and ventilated and his pupils became reactive again.As no neurological improvement was seen after 46 hours,CVVHDF was started. After two sessions of CVVHDF, hebecame increasingly responsive and extubated himself. At theend of CVVHDF his serum carbamazepine concentration haddecreased to 0.25 µg/mL. He completely recovered and wasdischarged on hospital day 5.Yildiz TS, et al. Continuous venovenous hemodiafiltration to treat controlled-release carbamazepine overdose in a pediatric patient. Pediatric Anesthesia 16:1176-1178, No. 11, Nov 2006 - Turkey 801045904

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Reactions 9 Dec 2006 No. 11310114-9954/10/1131-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved