Exacerbation of partial seizures and onset of nonepileptic myoclonus with carbamazepine.
A child had two to three generalized tonic-clonic (GTC) seizures per week unresponsive to phenobarbital (PB) and valproate (VPA). Interictal EEG demonstrated left occipital spikes. When carbamazepine (CBZ) therapy was started, he developed very frequent (4-6/day) complex partial seizures (CPS) characterized on ictal EEG by focal right temporal lobe discharges. The seizure exacerbation, which was associated with development of nonepileptic, multifocal myoclonus, resolved 24 h after CBZ was discontinued. The exacerbation occurred with therapeutic CBZ serum levels, but may have been related to the toxic levels of carbamazepine-10, 11-epoxide (CBZE).
Dhuna
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Department of Neurology, University of Minnesota, Minneapolis 55455.
Pascual-Leone
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Talwar
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D
D000208:Acute Disease; D002220:Carbamazepine / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000378:metabolism / Q000627:therapeutic use / Q000633:toxicity; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000188:drug therapy* / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000139:chemically induced* / Q000503:physiopathology; D006801:Humans; D007223:Infant; D008297:Male; D009207:Myoclonus / Q000139:chemically induced*; D009778:Occipital Lobe / Q000503:physiopathology; D013702:Temporal Lobe / Q000503:physiopathology
D002220:Carbamazepine; C012227:carbamazepine epoxide