Seizure after intrathecal baclofen bolus in a multiple sclerosis patient treated with oxcarbazepine

Autor: Leopold Saltuari, Giangaetano D'Aleo, Carmela Rifici, Edoardo Sessa, Markus Kofler, Placido Bramanti
Rok vydání: 2010
Předmět:
Adult
Olanzapine
Baclofen
medicine.medical_specialty
Multiple Sclerosis
Neurology
Spinal
Traumatic brain injury
Adult
Anticonvulsants

therapeutic use
Antipsychotic Agents

therapeutic use
Baclofen

administration /&/ dosage/adverse effects/therapeutic use
Benzodiazepines

therapeutic use
Carbamazepine

analogs /&/ derivatives/therapeutic use
Female
GABA-B Receptor Agonists

administration /&/ dosage/adverse effects/therapeutic use
Humans
Injections

Spinal
Multiple Sclerosis

Chronic Progressive
drug therapy
Seizures

chemically induced
Oxcarbazepine
Dermatology
Injections
Benzodiazepines
Bolus (medicine)
analogs /&/ derivatives/therapeutic use
Seizures
Humans
Medicine
Injections
Spinal

administration /&/ dosage/adverse effects/therapeutic use
business.industry
Multiple sclerosis
General Medicine
Multiple Sclerosis
Chronic Progressive

medicine.disease
drug therapy
Psychiatry and Mental health
Carbamazepine
therapeutic use
GABA-B Receptor Agonists
Anesthesia
Anticonvulsants
Female
Neurology (clinical)
Epileptic seizure
Neurosurgery
medicine.symptom
business
Antipsychotic Agents
medicine.drug
Popis: 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.
Databáze: OpenAIRE