Reactions 931 - 7 Dec 2002

★Oxcarbazepine

First report of generalised seizures in children:3 case reports

Oxcarbazepine [dosages not stated] led to induction orexacerbation of seizures in three children.

Patient 1, a 13-year-old girl with a history of complex partialseizures, had her carbamazepine treatment changed tooxcarbazepine; she was also receiving phenobarbital.Approximately 3 months later, she developed eye-flutteringepisodes and an EEG revealed generalised spike and slow-wave activity. Oxcarbazepine was discontinued and her eye-fluttering resolved.

Patient 2, a 5-year-old girl with a history of left-sided focalseizures, had been receiving oxcarbazepine and valproic acidwhen valproic acid was discontinued. Within 2 months shedeveloped frequent generalised convulsive seizures and anEEG revealed frequent bursts of generalised spike and slow-wave activity. Oxcarbazepine was discontinued and replacedwith zonisamide and her seizures improved.

Patient 3, aged 10 years [gender not stated], had a history ofeye-fluttering episodes and generalised convulsive seizures.The patient’s treatment was switched from phenytoin tooxcarbazepine [duration of treatment not stated] and eye-fluttering increased markedly; clumsiness and confusion alsodeveloped. An EEG showed frequent generalised spike andslow-wave discharges. Following discontinuation ofoxcarbazepine and initiation of valproic acid treatment, thepatient’s overall functioning and eye-fluttering improved.

Author comment: ‘It appears that OCBZ [oxcarbazepine]induced or exacerbated primary generalized epileptiformactivity in these patients, as evident by both clinical and EEGfindings.’Mandelbaum DE, et al. Apparent induction or exacerbation of primary generalizedseizures after initiation of oxcarbazepine. Epilepsia 43 (Suppl. 7): 208, 2002[abstract] - USA 800921350

» Editorial comment: A search of AdisBase and Medline didnot reveal any previous case reports of generalised seizuresassociated with oxcarbazepine. The WHO Adverse DrugReactions database contained 37 reports of convulsions, 26reports of aggravated convulsions and 19 reports of grand malconvulsions associated with oxcarbazepine.

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Reactions 7 Dec 2002 No. 9310114-9954/10/0931-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved