title: Focal seizures after treatment with fluvastatin in a patient with a history of catastrophic antiphospholipid syndrome.
abstract: We report a 36-year-old woman with the occurrence of painful focal seizures of her left hand and the left leg. She also had focal motor seizures at the left corner of her mouth. The duration and frequency of the episodes increased over four days from a few seconds once a day to frequent intervals lasting more than four hours at a time. The symptoms appeared one day after start of the treatment with fluvastatin (40 mg) administered in order to diminish the endothelial activation induced by antiphospholipid antibodies (aPL). The patient suffered from severe manifestations of the antiphospholipid syndrome (APS) including Catastrophic Antiphospholipid Syndrome (CAPS, Asherson's syndrome). In this case a single 40 mg dose of oral fluvastatin was linked to seizures. After discontinuation of this treatment, the seizures immediately disappeared and the patient fully recovered without evidence of permanent neurological damage. This data links statins to seizures in patients with compromised blood brain barrier such as APS.
authors.affiliation: Department of Internal Medicine III, University Hospital, Johann Wolfgang Goethe-University, Theodor-Stern Kai 7, 60590 Frankfurt/Main, Germany. miesbach@em.uni-frankfurt.de
authors.forename: Wolfgang
authors.initials: W
authors.lastname: Miesbach
authors.forename: Joab
authors.initials: J
authors.lastname: Chapman
authors.forename: Inge
authors.initials: I
authors.lastname: Scharrer
mesh_terms: D000328:Adult; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D001812:Blood-Brain Barrier / Q000502:physiology; D001921:Brain / Q000473:pathology; D004828:Epilepsies, Partial / Q000139:chemically induced*; D005229:Fatty Acids, Monounsaturated / Q000009:adverse effects* / Q000627:therapeutic use; D005260:Female; D000077340:Fluvastatin; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D007211:Indoles / Q000009:adverse effects* / Q000627:therapeutic use; D008279:Magnetic Resonance Imaging; D012640:Seizures / Q000139:chemically induced*
chemical_list: D005229:Fatty Acids, Monounsaturated; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D000077340:Fluvastatin