Carbamazepine
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Tonic-clonic seizure: case report A 54-year-old woman had a tonic-clonic seizure while receiving carbamazepine. The woman, who had been dependent on benzodiazepines for 8 years, was hospitalised. Before admission, she was taking up to 90 mg/day of bromazepam. An EEG was normal except for predominant β-waves, thought to be caused by benzodiazepines. Over 4 weeks, she was gradually tapered off benzodiazepines using diazepam. She received carbamazepine at an initial dose of 600mg [frequency not stated] to prevent withdrawal seizures. In week 6, 15 days after her last dose of benzodiazepine, after 38 days of treatment with carbamazepine and after her carbamazepine dose had been reduced to 200mg [frequency not stated], she suddenly reported suicidal ideas and showed symptoms of mild disorientation. After a few hours, she had a tonic-clonic seizure. An EEG revealed a left temporal focus with slow waves, and a brain MRI revealed several unspecific white matter lesions. Laboratory testing revealed the following levels: sodium 125 mmol/L, potassium 2.9 mmol/L and creatine kinase 171 U/L. The woman received an infusion of hypertonic solution. Her serum sodium level was monitored carefully. Mild fatty liver, multiple cysts in both kidneys and symptoms of chronic impairment were revealed by abdomen sonography. She recovered quickly and, after 63 days of treatment, was finally discharged with a sodium level of 137 mmol/L. Holtschmidt-T¨aschner B, et al. Hyponatremia-induced seizure during carbamazepine treatment. World Journal of Biological Psychiatry 8: 51-53, No. 1, 801090642 2007 - Germany
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Reactions 28 Jul 2007 No. 1162
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