Seizure after intrathecal baclofen bolus in a multiple sclerosis patient treated with oxcarbazepine.
Epileptic seizures associated with intrathecal baclofen (ITB) application have been observed in patients with traumatic brain injury. A higher incidence of seizures has also been reported in patients with multiple sclerosis (MS) receiving ITB. To our knowledge, no case of a first epileptic seizure has been reported in the context of ITB bolus testing in MS. We report a 41-year-old female patient with primary progressive MS receiving olanzapine and oxcarbazepine for psychotic disorder. Five years prior she began to develop severe spastic quadriparesis, rendering her a candidate for ITB treatment. After ITB test bolus application, however, she experienced a first epileptic seizure. Our observation indicates that ITB may trigger seizures in patients with MS. The observed seizure occurred during ITB bolus testing despite antiepileptic co-medication, which concurs with previous reports suggesting that rapid changes in the dose of ITB may carry a higher risk of seizure induction.
D'Aleo
Giangaetano
G
IRCCS Centro Neurolesi Bonino-Pulejo, via Provinciale Palermo, 98124, Messina, Italy. gngdaleo@alice.it
Rifici
Carmela
C
Kofler
Markus
M
Sessa
Edoardo
E
Saltuari
Leopold
L
Bramanti
Placido
P
D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000627:therapeutic use; D001418:Baclofen / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D002220:Carbamazepine / Q000031:analogs & derivatives / Q000627:therapeutic use; D005260:Female; D058786:GABA-B Receptor Agonists / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007278:Injections, Spinal; D020528:Multiple Sclerosis, Chronic Progressive / Q000188:drug therapy*; D000077152:Olanzapine; D000078330:Oxcarbazepine; D012640:Seizures / Q000139:chemically induced*
D000927:Anticonvulsants; D014150:Antipsychotic Agents; D058786:GABA-B Receptor Agonists; D001569:Benzodiazepines; D002220:Carbamazepine; D001418:Baclofen; D000077152:Olanzapine; D000078330:Oxcarbazepine