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Non
convulsive status epilepticus after replacement of valproate with lamotrigine
Trinka E,
Dilitz E, Unterberger I, Luef G, Deisenhammer F, Niedermuller U, Thaler C, Bauer
G
Universitatsklinik
fur Neurologie, Anichstrasse 35, 6020 Innsbruck, Austria.
eugen.trinka@uklibk.ac.at
Purpose.
Lamotrigine (LTG) and valproate (VPA) are widely used in the treatment of
generalized epilepsies.
Nevertheless seizure aggravation with LTG has been reported in juvenile
myoclonic epilepsy and epilepsy with myoclonic absences.
The aim of this study was to describe clinical features and EEG findings in
patients with non convulsive status epilepticus (NCSE) after replacement of VPA
with LTG.
Method.
Retrospective analysis of three identified patients in a large university
hospital.
Results.
We describe three adult patients aged 39, 50 and 75 years, who developed
non-convulsive status epilepticus (NCSE) after replacement of VPA with LTG.
The episodes of NCSE presented as an acute confusional state with mild myoclonus.
Ictal EEG showed generalized spike-wave or polyspike wave activity.
The clinical symptoms and the EEG responded promptly to IV benzodiazepines and
patients remained well controlled with dose reduction of LTG (in one patient) or
discontinuation of LTG (in two patients).
Conclusion.CONCLUSION:
The reported episodes of NCSE in these patients with generalized epilepsy may be
either due to a possible paradoxical reaction to LTG or due to a withdrawal
effect of VPA.
PMID:
12382160 [PubMed - in process]
Source:
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12382160&dopt=Abstract
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