Worsening of Seizures by Carbamazepine
Abstract number :
3.114
Submission category :
Year :
2001
Submission ID :
194
Source :
www.aesnet.org
Presentation date :
12/1/2001 12:00:00 AM
Published date :
Dec 1, 2001, 06:00 AM
Authors :
D.N. Gullapalli, M.D., Neurology, University of Virginia, Charlottesville, VA; C.. Schwaner, Neurology, University of Virginia, Charlottesville, VA; M.. Quigg, M.D., Neurology, University of Virginia, Charlottesville, VA
RATIONALE: Introduction:
Paradoxical worsening of seizures is a known but underappreciated complication of antiepileptic drug (AED) treatment. Carbamazepine (CBZ) has been shown to worsen generalized seizures, but the incidence and risk factors of these complications are unclear.
METHODS: We searched the computerized database of a tertiary epilepsy clinic to identify all patients who were treated with CBZ between 4/1998-4/2001. Clinic records were reviewed for those patients in whom CBZ was discontinued for worsening of seizures.
RESULTS: 671 patients were treated with CBZ over a three year period. Of the 331 patients in whom CBZ was discontinued, exacerbation of seizures was the reason for discontinuation in 7 patients (2% of discontinued, 1% of all patients treated with CBZ). The mean age of the subjects at the time of CBZ initiation was 3.9 +/- 3.3 years. Three patients had generalized and 4 had localization-related epilepsies. Two subjects presented with convulsive status epilepticus. The remainder experienced exacerbation of their typical seizures. Three of seven patients were on combined therapy with VPA, and 4 were taking additional AEDs.
CONCLUSIONS: This study suggests that age [lt] 4 years and AED polypharmacy are risk factors in the exacerbation of seizures during CBZ treatment. Although previous studies determined that patients with generalized epilepsies were at most risk, we find that both localization-related and generalized epilepsies can be equally susceptible.