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Lack of additional effect, somnolence and walking difficulties: case report A girl [exact age at reactions onsets not stated] exhibited a lack of additional effect during treatment with levitiracetam for epilepsy. Later, she developed somnolence and walking difficulties during treatment with carbamazepine for paroxysmal movement disorder [routes and times to reactions onsets not stated; not all dosages stated]. The girl, whose medical history was notable for respiratory distress, jaundice and delayed developmental milestones, was diagnosed with paroxysmal movement disorder and developmental and epileptic encephalopathy with RHOBTB2 gene. She had a family history of bipolar disorder (father). For the treatment of epilepsy, she started receiving valproate at the age of 3 months. Later, she additionally started receiving topiramate and levetiracetam for limited time periods. However, she exhibited lack of additional effect during treatment with levetiracetam. Therefore, the girl’s treatment with levetiracetam was discontinued. Also, topiramate was stopped due to loss of appetite [aetiology unknown]. At the age of 8 years, while she had been receiving valproate, she presented to a clinic. She then started receiving treatment with a titration scheme of carbamazepine. Initially, she started receiving carbamazepine 5 mg/kg/day, which was increased by 5 mg/kg/day every 5 days up to a planned maintenance dose of 20 mg/kg/day. However, she developed somnolence and walking difficulties secondary to high doses of carbamazepine. Therefore, the dose of carbamazepine was reduced to 10 mg/kg/day. She continued to receive carbamazepine 10 mg/kg/day, without any side-effects. Also, the paroxysmal movement disorder resolved completely following carbamazepine initiation. No recurrence was noted during 14-month follow-up. Spagnoli C, et al. Paroxysmal movement disorder with response to carbamazepine in a patient with RHOBTB2 developmental and epileptic encephalopathy. Parkinsonism and Related Disorders 76: 54-55, Jul 2020. Available from: URL: http://doi.org/10.1016/j.parkreldis.2020.05.031 803505654

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Reactions 10 Oct 2020 No. 1825