Worsening of seizures by oxcarbazepine in juvenile idiopathic generalized epilepsies.
OBJECTIVE
Several studies have shown that carbamazepine (CBZ) may aggravate idiopathic generalized epilepsy (IGE). Oxcarbazepine (OXC) is a new drug chemically related to CBZ. We report six cases of juvenile IGE with a clear aggravation by OXC.


METHODS
We retrospectively studied all patients with IGE first referred to our epilepsy department between January 2001 and June 2003 and treated with OXC.


RESULTS
During this period, six patients were identified. All had an aggravation of their epilepsy in both clinical and EEG activities. OXC had been used because of an incorrect diagnosis of focal epilepsy or generalized tonic-clonic seizures (GTCSs) of undetermined origin (no syndromic classification of the epilepsy). Before OXC, only one patient had experienced a worsening of seizures with an inadequate drug (CBZ). Four had juvenile myoclonic epilepsy, one had juvenile absence epilepsy, and one had IGE that could not be classified into a precise syndrome. OXC (dosage range, 300-1,200 mg/day) was used in monotherapy in all of them except for one patient. Aggravation consisted of a clear aggravation of myoclonic jerks (five cases) or de novo myoclonic jerks (one case). Three patients had exacerbation of absence seizures. One patient had worsened dramatically and had absence status, and one had de novo absences after OXC treatment. The effects of OXC on GTCSs were less dramatic, with no worsening in frequency in three and a slight increase in three.


CONCLUSIONS
OXC can be added to the list of antiepileptic drugs that can exacerbate myoclonic and absence seizures in IGE.
Epilepsy Unit, Hôpital Gui de Chauliac, Montpellier, France.
Philippe
P
Gelisse
Pierre
P
Genton
Callixte
C
Kuate
Aurélie
A
Pesenti
Michel
M
Baldy-Moulinier
Arielle
A
Crespel
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use*; D002220:Carbamazepine / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000627:therapeutic use*; D002648:Child; D003951:Diagnostic Errors; D004334:Drug Administration Schedule; D004828:Epilepsies, Partial / Q000175:diagnosis; D004832:Epilepsy, Absence / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D004829:Epilepsy, Generalized / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D006801:Humans; D008297:Male; D020190:Myoclonic Epilepsy, Juvenile / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D000078330:Oxcarbazepine
D000927:Anticonvulsants; D002220:Carbamazepine; D000078330:Oxcarbazepine