SEIZURE EXACERBATION AND DEVELOPMENTAL REGRESSION WITH CARBAMAZEPINE

Citation
An. Prasad et al., SEIZURE EXACERBATION AND DEVELOPMENTAL REGRESSION WITH CARBAMAZEPINE, Canadian journal of neurological sciences, 25(4), 1998, pp. 287-294
Citations number
29
Categorie Soggetti
Clinical Neurology
ISSN journal
03171671
Volume
25
Issue
4
Year of publication
1998
Pages
287 - 294
Database
ISI
SICI code
0317-1671(1998)25:4<287:SEADRW>2.0.ZU;2-M
Abstract
Background: Unexpected exacerbation of seizures may occur following in itiation of treatment with carbamazepine (CBZ). We reviewed the occurr ence of such reactions in our patient population at a tertiary care ch ildren's hospital. Methods: A retrospective analysis of our clinic dat abase identified 129/691 (18.6%) patients with epilepsy treated with C BZ, as monotherapy. 38/129 children were later switched to another dru g. In 11/38 (28.5%) clinical and/or EEG deterioration was observed. Tw o patients identified at another institution with similar exacerbation were also included in our analysis. We report on the findings in thes e 13 cases. Results: Two groups were identified: Group I - 6 patients with normal neurological exam, normal EEG background, and a diagnosis of idiopathic generalized epilepsy. Group II - 7 patients with an abno rmal neurological exam and/or abnormal EEG background. Following intro duction of CBZ therapy, worsening of preexisting seizures, appearance of new seizure types, behavioral regression, and accompanying EEG dete rioration were reported in both groups. Dramatic improvement in seizur e control occurred, following withdrawal of CBZ and substitution of an other anticonvulsant. Conclusion: Physicians treating epilepsy must be aware that CBZ can exacerbate seizures, and cause developmental regre ssion in children. Careful patient selection, when choosing CBZ as tre atment, and prompt recognition of clinical deterioration and intervent ion, may help avoid or reverse these paradoxical reactions.