title: Aggravation of atonic seizures by rufinamide: A case report.
abstract: BACKGROUND
  Rufinamide is a novel antiepileptic drug used as adjunctive therapy in patients with Lennox-Gastaut syndrome and provides seizure control especially in tonic and atonic seizures. Rufinamide is expected to be effective in intractable epilepsy when atonic and tonic seizures exist. However, rufinamide induced seizure aggravation has been reported in a few patients, which was not associated with a specific type of seizure.
  
  
  METHODS
  A 12-year-old boy with intractable epilepsy had tonic and atonic seizures despite treatment with valproic acid (3000mg/day), levetiracetam (3000mg/day) and clobazam (40mg/day). Rufinamide was administered as adjuvant therapy. After 2weeks on rufinamide, he experienced atonic seizure worsening, and the frequency of epileptic discharges increased. The deterioration in seizure frequency and epileptiform discharges resolved when rufinamide was discontinued.
  
  
  CONCLUSIONS
  Rufinamide may aggravate atonic seizures in patients with intractable epilepsy.
authors.affiliation: Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey. Electronic address: goncabektas@gmail.com.
authors.forename: Gonca
authors.initials: G
authors.lastname: Bektaş
authors.affiliation: Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Mine
authors.initials: M
authors.lastname: Çalışkan
authors.affiliation: Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Aydın
authors.affiliation: Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Edibe
authors.initials: E
authors.lastname: Pembegül Yıldız
authors.affiliation: Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Tatlı
authors.affiliation: Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Nur
authors.initials: N
authors.lastname: Aydınlı
authors.affiliation: Department of Pediatric Neurology, Istanbul Medical Faculty, Istanbul University, Turkey.
authors.forename: Meral
authors.initials: M
authors.lastname: Özmen
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D001921:Brain / Q000187:drug effects / Q000503:physiopathology; D002648:Child; D000078306:Clobazam; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy* / Q000503:physiopathology*; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D006801:Humans; D000077287:Levetiracetam; D008297:Male; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use; D012640:Seizures / Q000188:drug therapy* / Q000503:physiopathology*; D014230:Triazoles / Q000009:adverse effects* / Q000627:therapeutic use; D014635:Valproic Acid / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014230:Triazoles; D001569:Benzodiazepines; D000078306:Clobazam; D000077287:Levetiracetam; D014635:Valproic Acid; C079703:rufinamide; D010889:Piracetam
keywords: Atonic; Intractable epilepsy; Rufinamide; Seizure