De novo absence status epilepticus as a benzodiazepine withdrawal syndrome.
A 67-year-old woman with a history of psychotropic drug abuse developed confusion. EEG was consistent with absence status epilepticus (AS). Intravenous (i.v.) flumazenil 1 mg, a benzodiazepine antagonist with anticonvulsant properties, increased both confusion and paroxysmal activity. Complete resolution was obtained after diazepam was administered i.v., and the patient then admitted that she had abruptly discontinued long-standing treatment with carpipramine, amitriptyline, bromazepam, and flunitrazepam. The aggravating effect of flumazenil indicates that benzodiazepine withdrawal was probably the elective triggering factor of this de novo absence status epilepticus.
Service de Neurologie, Hôpital Pasteur, Nice, France.
P
P
Thomas
C
C
Lebrun
M
M
Chatel
D000368:Aged; D001569:Benzodiazepines / Q000009:adverse effects* / Q000506:poisoning / Q000627:therapeutic use; D001714:Bipolar Disorder / Q000188:drug therapy; D003975:Diazepam / Q000627:therapeutic use; D004569:Electroencephalography / Q000187:drug effects; D005260:Female; D005442:Flumazenil / Q000494:pharmacology / Q000627:therapeutic use; D006801:Humans; D011963:Receptors, GABA-A / Q000187:drug effects; D013226:Status Epilepticus / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy; D013375:Substance Withdrawal Syndrome / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*
D011963:Receptors, GABA-A; D001569:Benzodiazepines; D005442:Flumazenil; D003975:Diazepam