https://scholars.lib.ntu.edu.tw/handle/123456789/527447
標題: | Anti-epileptic drugs-induced de novo absence seizures | 作者: | Yang M.-T. WANG-TSO LEE Chu L.-W. Shen Y.-Z. |
關鍵字: | Absence epilepsy; Carbamazepine; Children; Vigabatrin | 公開日期: | 2003 | 出版社: | Elsevier B.V. | 卷: | 25 | 期: | 1 | 起(迄)頁: | 51-56 | 來源出版物: | Brain and Development | 摘要: | The authors present three patients with de novo absence epilepsy after administration of carbamazepine and vigabatrin. Despite the underlying diseases, the prognosis for drug-induced de novo absence seizure is good because it subsides rapidly after discontinuing the use of the offending drugs. The γ-aminobutyric acid-transmitted thalamocortical circuitry accounts for a major part of the underlying neurophysiology of the absence epilepsy. Because drug-induced de novo absence seizure is rare, pro-absence drugs can only be considered a promoting factor. The underlying epileptogenecity of the patients or the synergistic effects of the accompanying drugs is required to trigger the de novo absence seizure. The possibility of drug-induced aggravation should be considered whenever an unexpected increase in seizure frequency and/or new seizure types appear following a change in drug treatment. By understanding the underlying mechanism of absence epilepsy, we can avoid the inappropriate use of anticonvulsants in children with epilepsy and prevent drug-induced absence seizures. ? 2002 Elsevier Science B.V. All rights reserved.Patients:2 boys aged 7 years and 12 years and 4 months, one 6 year old girl (dropout).TypeofStudy:3 case reports on drug-induced absence seizures associated with Tegretol.Indications:3 patients with complex partial seizure, generalized tonic-clonic convulsion, or partial epilepsy with secondary generalization.DosageDuration:Dosage not stated. Duration: > 4 months (n=1).Results:Patient 1: 4 months after administration of Tegretol to treat complex partial seizures, the patient suffered frequent vacant spells, lasting 2-3 s each time. Hyperventilation also induced a vacant spell for 10-20 s. EEG showed 3 cps spike-and-wave complexes coinciding with clinical attacks. Tegretol was tapered and VPA was increased gradually. No more seizures have been reported for more than five years. Patient 2 (untreated febrile convulsions) developed an episode of vacant staring for up to 3-15 min at age 4 years 5 months. EEG showed focal spikes and Tegretol was given under the impression of complex partial epilepsy. Because of recurrent seizures over a 3-month period, Tegretol and LTG were administered for seizure control. Head magnetic resonance imaging showed a focal area of mildly increased signals at right anterior hippocampus with somewhat blurred gray-white matter junction. Vigabatrin (VGB) added at 5 years of age because of persistent seizure attacks, LTG discontinued. Seizure frequency decreased. Patient 3 was given Tegretol for partial epilepsy with secondary generalization. After 2 months he developed absence-like seizures. EEG showed spike-waves with focality over the bilateral parietal and occipital areas. VPA was added. Only occasional seizure attacks since then.AdverseEffects:Absence epilepsy developed in 3 patients.FreeText:Concomitant drugs taken were valproic acid (VPA) (patient 1), lamotrigine (LTG) and vigabatrin (VGB) (patient 2), VPA (patient 3)AuthorsConclusions:The possibility of drug-induced aggravation should be considered whenever an unexpected increase in seizure frequency and/or new seizure types appear following a change in drug treatment. By understanding the underlying mechanism of absence epilepsy, we can avoid the inappropriate use of anticonvulsants in children with epilepsy and prevent drug-induced absence seizures. |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-0037248924&doi=10.1016%2fs0387-7604%2802%2900120-1&partnerID=40&md5=e12e31bcaa4f7aa0ba497025687b2059 https://scholars.lib.ntu.edu.tw/handle/123456789/527447 |
ISSN: | 0387-7604 | DOI: | 10.1016/s0387-7604(02)00120-1 | SDG/關鍵字: | 4 aminobutyric acid; anticonvulsive agent; carbamazepine; lamotrigine; valproic acid; vigabatrin; absence; article; case report; child; clinical feature; complex partial seizure; convulsion; electroencephalography; epileptogenesis; febrile convulsion; female; human; hyperventilation; male; neurophysiology; nuclear magnetic resonance imaging; prognosis; thalamocortical tract; treatment outcome |
顯示於: | 醫學系 |
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