Autonomic epilepsy: clonidine blockade of paroxysmal catecholamine release and flushing.
We studied a 59-year-old man with transient paroxysms of hypertension, tachycardia, and flushing in whom pheochromocytoma was excluded. Although catecholamine excretion was normal, plasma catecholamine levels rose from normal basal levels (282 +/- 14 pg/ml) to increased levels (585 +/- 67 pg/ml; x +/- SEM; n = 4) at the peak of spells. Other hormones or substrates expected to rise with nonspecific "stress" did not increase after paroxysms. Therapy with clonidine (0.2 to 0.4 mg/day) suppressed basal catecholamines to undetectable levels and markedly reduced peak levels during spells (80 pg/ml). An epileptic pathogenesis was suggested by stereotypic olfactory and epigastric prodromata before spells, and abolition of paroxysms with the anticonvulsant carbamazepine. This patient represents a rare case of autonomic epilepsy with the seizure focus in the temporal lobe.
D001341:Autonomic Nervous System; D002220:Carbamazepine / Q000627:therapeutic use; D002395:Catecholamines / Q000097:blood / Q000378:metabolism* / Q000652:urine; D002979:Climacteric; D003000:Clonidine / Q000494:pharmacology / Q000627:therapeutic use*; D004827:Epilepsy / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis; D006801:Humans; D006973:Hypertension / Q000175:diagnosis; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000150:complications; D013610:Tachycardia / Q000175:diagnosis
D002395:Catecholamines; D002220:Carbamazepine; D003000:Clonidine