title: Oxcarbazepine-induced myoclonic status epilepticus in juvenile myoclonic epilepsy.
abstract: Juvenile myoclonic epilepsy (JME) is a frequent idiopathic generalised epilepsy syndrome with typical clinical and EEG features that can usually be controlled by valproate monotherapy. JME may be underdiagnosed or misdiagnosed; in the latter case, it may be mistaken for partial epilepsy. The incorrect diagnosis of JME is likely to result in inappropriate therapy, which may, in turn, worsen the seizures. While a number of studies have documented that carbamazepine aggravates idiopathic generalised epilepsy, few have shown a worsening of symptoms following the administration of oxcarbazepine (OXC). We report the case of a 44-year-old male affected by JME in which the inappropriate use of OXC precipitated a dramatic worsening of myoclonic seizures. In this case, video-EEG monitoring documented myoclonic status epilepticus with positive and negative myoclonus, correlating with repetitive, continuous, rhythmic, generalised polyspike-and-wave discharges. This is the first case of myoclonic status epilepticus induced by OXC in a patient with JME which is clearly documented by video-EEG. A review of the literature with regards to OXC-induced worsening of seizures is also presented. [Published with video sequences].
authors.affiliation: Department of Neurology and Psychiatry, Sapienza University of Rome, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Fanella
authors.forename: Gabriella
authors.initials: G
authors.lastname: Egeo
authors.forename: Jinane
authors.initials: J
authors.lastname: Fattouch
authors.forename: Sara
authors.initials: S
authors.lastname: Casciato
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lapenta
authors.forename: Alessandra
authors.initials: A
authors.lastname: Morano
authors.forename: Anna Teresa
authors.initials: AT
authors.lastname: Giallonardo
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Bonaventura
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects*; D002220:Carbamazepine / Q000009:adverse effects / Q000031:analogs & derivatives*; D003951:Diagnostic Errors; D004828:Epilepsies, Partial / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D008297:Male; D020190:Myoclonic Epilepsy, Juvenile / Q000175:diagnosis* / Q000188:drug therapy; D000078330:Oxcarbazepine; D013226:Status Epilepticus / Q000139:chemically induced*
chemical_list: D000927:Anticonvulsants; D002220:Carbamazepine; D000078330:Oxcarbazepine
keywords: JME; OXC; juvenile myoclonic epilepsy; myoclonic status epilepticus; seizure; worsen