title: A 33-year-old patient with human immunodeficiency virus on antiretroviral therapy with efavirenz-induced complex partial seizures: a case report.
abstract: BACKGROUND
  Efavirenz is a commonly prescribed antiretroviral drug that is largely well tolerated. However, seizure disorder is a rare side effect. Prompt identification and immediate replacement of efavirenz with an alternative drug would effectively stop the seizures. To the best of our knowledge, we present the first reported case in the literature of complex partial seizures arising due to efavirenz.
  
  
  METHODS
  We report a case of a 33-year-old Nigerian man treated with an efavirenz-based antiretroviral regimen for human immunodeficiency virus infection. He presented with seizures soon after commencement of antiretroviral drugs. His magnetic resonance imaging results were unremarkable. His blood levels of sodium, glucose, urea, and creatinine were within normal limits. However, his electroencephalogram showed intermittent bursts of high-voltage sharp waves and spikes bilaterally over frontotemporoparietal regions, a finding consistent with complex partial seizures. His efavirenz plasma level was 209.55 μg/ml. His seizures stopped following a switch to a non-efavirenz-based regimen.
  
  
  CONCLUSIONS
  This report brings to light the occurrence of complex partial seizures in patients on efavirenz. It also demonstrates the effective resolution of seizures when efavirenz treatment is replaced with a non-efavirenz-based regimen.
authors.affiliation: Jos University Teaching Hospital, Jos, Plateau State, Nigeria. nyshehu@yahoo.com.
authors.forename: Nathan Yakubu
authors.identifier: http://orcid.org/0000-0001-8802-4928
authors.initials: NY
authors.lastname: Shehu
authors.affiliation: Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
authors.forename: Victor
authors.initials: V
authors.lastname: Ojeh
authors.affiliation: Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
authors.forename: Godwin
authors.initials: G
authors.lastname: Osaigbovo
authors.affiliation: Jos University Teaching Hospital, Jos, Plateau State, Nigeria.|University of Jos, Jos, Plateau State, Nigeria.
authors.forename: Patricia
authors.initials: P
authors.lastname: Agaba
authors.affiliation: Jos University Teaching Hospital, Jos, Plateau State, Nigeria.|University of Jos, Jos, Plateau State, Nigeria.
authors.forename: Oche
authors.initials: O
authors.lastname: Agbaji
mesh_terms: D000328:Adult; D000480:Alkynes; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D048588:Benzoxazines / Q000009:adverse effects*; D003521:Cyclopropanes; D015658:HIV Infections / Q000188:drug therapy*; D006801:Humans; D008297:Male; D018894:Reverse Transcriptase Inhibitors / Q000009:adverse effects*; D012640:Seizures / Q000139:chemically induced*
chemical_list: D000480:Alkynes; D048588:Benzoxazines; D003521:Cyclopropanes; D018894:Reverse Transcriptase Inhibitors; C098320:efavirenz
keywords: Efavirenz; HIV; Seizures