Tiagabine overdose: a case of status epilepticus in a non-epileptic patient.
Tiagabine is an antiepileptic drug used as adjunctive therapy for partial seizures that is believed to selectively inhibit the presynaptic reuptake of gamma aminobutyric acid (GABA). We describe a case of a tiagabine overdose that resulted in status epilepticus (SE) in a patient with no seizure history. A 14-year-old girl with a history of asthma presented with convulsive SE after ingestion of an unknown amount of her sister's tiagabine in a suicide attempt. Attempted anticonvulsant therapy included a total of diazepam 10 mg IV, lorazepam 6 mg IV, pyridoxine 5 g IV, and fosphenytoin 20 mg PE/kg. All were without effect. A computed tomography and electrocardiogram were normal. Continuous bedside EEG monitoring showed suppression of seizure activity following intravenous midazolam. A tiagabine level obtained on ED arrival was 420 ng/mL (therapeutic 20-103 ng/mL). The patient was discharged to psychiatry within 1 week with no neurologic sequelae.
Fulton
Jessica A
JA
New York City Poison Control Center, New York, NY 10016, USA. jessicafulton@yahoo.com
Hoffman
Robert S
RS
Nelson
Lewis S
LS
D000293:Adolescent; D000927:Anticonvulsants / Q000506:poisoning*; D062787:Drug Overdose / Q000628:therapy; D005260:Female; D006801:Humans; D009557:Nipecotic Acids / Q000506:poisoning*; D013226:Status Epilepticus / Q000139:chemically induced* / Q000628:therapy; D013406:Suicide, Attempted; D000078308:Tiagabine; D016896:Treatment Outcome
D000927:Anticonvulsants; D009557:Nipecotic Acids; D000078308:Tiagabine