Rasmussen syndrome: absence seizures may be induced by oxcarbazepine
Rasmussen syndrome: absence seizures may be induced by oxcarbazepine
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DOI：
10.1684/epd.2019.1035
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发表时间：
2019-02-01
影响因子：
2.3
通讯作者：
Calvo, Agustin
中科院分区：
文献类型：
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作者：
Caraballo, Roberto H.;Cachia, Pedro;Calvo, Agustin
一名具有与拉斯穆森综合征相符的电临床和神经放射学特征的女性患者出现了特殊的临床和脑电图模式。由于丙戊酸钠 750 mg/kg/天难以治疗癫痫发作，因此添加了 30 mg/kg/天的奥卡西平 (OXC)。癫痫发作变得更加频繁，神经系统检查未发现偏瘫。发作间期脑电图显示右侧额颞区局灶性尖峰和弥漫性阵发。脑部核磁共振显示右半身萎缩，主要发生在侧裂处。每天开始 OXC 后，观察到短暂失神发作，持续时间不到 20 秒，并伴有与典型失神兼容的双侧同步 2.5-3-Hz 尖峰和波。 OXC 被终止，典型的缺勤现象消失了。开始静脉注射丙种球蛋白治疗。在九岁时的最后一次对照访视中，父母或脑电图记录均未观察到失神发作。我们的患者符合拉斯穆森综合征的诊断标准，出现失神发作，可能是由 OXC 引起的。 OXC 停药后，失神发作消失。
A female patient with electroclinical and neuroradiological features compatible with Rasmussen syndrome developed a particular clinical and EEG pattern. As the seizures were refractory to valproate at 750 mg/kg/day, oxcarbazepine (OXC) at 30 mg/kg/day was added. Seizures became more frequent and on neurological examination, no hemiparesis was detected. The interictal EEG showed focal spikes and diffuse paroxysms in the right fronto-temporal regions. Brain MRI revealed right hemiatrophy, mainly at the Sylvian fissure. After initiating OXC daily, brief absence seizures, lasting less than 20 seconds and associated with bilateral and synchronous 2.5-3-Hz spike-and-waves compatible with typical absences, were observed. OXC was discontinued and the typical absences disappeared. Treatment with intravenous gammaglobulin was started. At the last control visit, at nine years of age, no absence seizures were observed either by the parents or on the EEG recording. Our patient who met the diagnostic criteria for Rasmussen syndrome presented with absence seizures that may have been induced by OXC. The absence seizures disappeared after OXC was discontinued.