Antiepileptics
- PDF / 170,538 Bytes
- 1 Pages / 595.245 x 841.846 pts (A4) Page_size
- 104 Downloads / 182 Views
1 S
Lack of efficacy: case report A 30-month-old male child exhibited a lack of efficacy during antiepileptic treatment with clobazam, levetiracetam, topiramate and valproate for febrile seizure and epilepsy with myoclonic-atonic seizures [dosages and routes not stated]. The child had a febrile seizure at the age of 26 months. At the age of 28 months, he experienced unprovoked seizures with signs of upward eye deviation, deep breathing and limpness, occurring every 2 weeks. Hence, he started receiving levetiracetam. However, at the age of 30 months, he was hospitalised due to convulsive status epilepticus. A continuous video encephalography (cvEEG) revealed background with disorganised δ and frequencies, generalised polyspike with wave discharges and continuous bitemporal slowing. At the age of 31 months, cvEEG showed myoclonic seizures occurring 2–3 times per hour, along with atonic seizures twice daily and bilateral tonic seizures once daily. With a seizure onset, his memory and language development became impaired. He also had a mild motor delay in walking at the 18–24 months of age. Based on his presentation, epilepsy with myoclonic-atonic seizures was suspected. Therefore, antiepileptic treatment was initiated, which included the sequential addition of clobazam, topiramate and valproate; however, his seizures worsened. A cvEEG (at the age of 42 months) showed atonic seizures once an hour and seizures with behavioral arrest. He also had a mild loss of tone and experienced myoclonic jerks 10 times per hour. Am epilepsy gene panel showed a paternally inherited p.R89H variant of uncertain importance in SCN1B. His father had no history of epilepsy, while his maternal grandmother had self-resolving childhood seizures. Because of subacute deterioration of the seizure burden, the child was hospitalised and started receiving phenytoin. Subsequently, his seizures slowly resolved. Afterwards, his antiepileptic treatment with valproate, levetiracetam, topiramate and clobazam was stopped sequentially. His school performance and language development improved. Dang LT, et al. Dramatic Improvement in Seizures With Phenytoin Treatment in an Individual With Refractory Epilepsy and a SCN1B Variant. Pediatric Neurology 108: 803500286 121-122, Jul 2020. Available from: URL: http://doi.org/10.1016/j.pediatrneurol.2020.03.012
0114-9954/20/1821-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
Reactions 12 Sep 2020 No. 1821
Data Loading...
