Antiepileptics/ketamine/thiamine

  • PDF / 169,824 Bytes
  • 1 Pages / 595.245 x 841.846 pts (A4) Page_size
  • 68 Downloads / 207 Views

DOWNLOAD

REPORT

1 S

Antiepileptics/ketamine/thiamine Tremor, akathisia and lack of efficacy: case report

A 37-year-old man developed tremor and akathisia during treatment with levothyroxine sodium. Additionally, he experienced lack of efficacy during treatment with ketamine, thiamine and thiopental sodium in status epilepticus [routes and dosages not stated]. The man with a history of HIV and Mycobacterium aviumintracellulare, presented with severe hypocalcemia, hypomagnesemia and hypokalemia. He also showed osteoporosis and mild hypothyroidism. He was appropriately treated and showed improvement. He also had a history of status epilepticus and had been receiving levothyroxine sodium. After 6 months, he presented with tremor, insomnia, restlessness and general malaise. A physical examination was significant for distal tremor and akathisia, attributed to a recent increase of levothyroxine sodium. His condition worsened and he developed facial myoclonus and right hemiparesis with pyramidal signs. He was treated with high-dose parenteral thiamine, however, he showed no improvement. He became stuporous with persistent facial myoclonus. He was diagnosed with super-refractory status epilepticus and he showed diffuse, continuous and recurrent bilateral frontotemporal epileptic seizures despite treatment with thiopental and ketamine induced medical coma. His microbiological tests were negative. Subsequently, he showed progressive worsening. Neuropathological examination showed diffuse polioencephalitis/encephalopathy with diffuse and prominent cortical and subcortical gliosis and focal microglial nodules. Subsequently, a diagnosis of measles inclusion body encephalitis was confirmed. Aldecoa I, et al. Image of the month: Measles inclusion body encephalitis. Clinical Neuropathology 39: 148-151, No. 4, Aug 2020. Available from: URL: http:// doi.org/10.5414/NP301283

0114-9954/20/1833-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved

803518800

Reactions 5 Dec 2020 No. 1833

Data Loading...