PMID- 11077464
OWN - NLM
STAT- MEDLINE
DCOM- 20010111
LR  - 20190813
IS  - 0013-9580 (Print)
IS  - 0013-9580 (Linking)
VI  - 41
IP  - 11
DP  - 2000 Nov
TI  - Frontal nonconvulsive status epilepticus associated with high-dose tiagabine 
      therapy in a child with familial bilateral perisylvian polymicrogyria.
PG  - 1485-8
AB  - PURPOSE: Antiepileptic drugs are known to exacerbate absence and myoclonic 
      seizures, especially in patients with idiopathic generalized epilepsies. 
      Exacerbation of nonconvulsive generalized seizures in patients with partial 
      epilepsy is less common. Recently, however, a number of cases of putative 
      generalized nonconvulsive status epilepticus (NCSE) or NCSE without further 
      specification have been reported in patients with chronic partial epilepsy 
      treated with the gamma-aminobutyric acid reuptake inhibitor tiagabine. Although 
      complex partial status epilepticus during tiagabine therapy has also been 
      reported, possible precipitation of NCSE specifically associated with frontal 
      lobe discharges does not appear to have been recognized. In this communication, 
      we describe the case of a boy with familial bilateral perisylvian polymicrogyria 
      who developed frontal NCSE after being stabilized on high-dose tiagabine METHODS: 
      A 12-year-old boy with familial bilateral perisylvian polymicrogyria, mental 
      retardation, and refractory partial seizures was administered tiagabine in 
      addition to sodium valproate. The tiagabine dosage was increased gradually up to 
      10 mg t.i.d. (1 mg/kg per day), resulting in complete seizure control. RESULTS: 
      After 1 week on maintenance treatment, seizures were completely controlled, but 
      the child developed hypoactivity, decreased reactivity, and affective detachment. 
      An EEG recording revealed subcontinuous sharp-wave discharges with irregular runs 
      of atypical spike-wave complexes over the anterior regions of both hemispheres, 
      consistent with a diagnosis of frontal NCSE. A reduction in tiagabine dosage to 
      15 mg/day led to complete regression of the behavioral and affective changes and 
      to disappearance of the subcontinuous EEG discharges. CONCLUSIONS: Although 
      tiagabine-induced NCSE has been described previously, particularly in patients 
      with preexisting spike-wave abnormalities, this is the first report that 
      identifies its potential role in the precipitation of frontal NCSE.
FAU - Piccinelli, P
AU  - Piccinelli P
AD  - Child Neuropsychiatry Unit, University of Insubria, "Fondazione Macchi" Hospital, 
      Varese, Italy. ppiccine@tin.it
FAU - Borgatti, R
AU  - Borgatti R
FAU - Perucca, E
AU  - Perucca E
FAU - Tofani, A
AU  - Tofani A
FAU - Donati, G
AU  - Donati G
FAU - Balottin, U
AU  - Balottin U
LA  - eng
PT  - Case Reports
PT  - Journal Article
PL  - United States
TA  - Epilepsia
JT  - Epilepsia
JID - 2983306R
RN  - 0 (Anticonvulsants)
RN  - 0 (Nipecotic Acids)
RN  - Z80I64HMNP (Tiagabine)
SB  - IM
MH  - Anticonvulsants/*adverse effects/therapeutic use
MH  - Brain/*abnormalities
MH  - Child
MH  - Dose-Response Relationship, Drug
MH  - Drug Administration Schedule
MH  - Electroencephalography/statistics & numerical data
MH  - Epilepsies, Partial/*drug therapy
MH  - Epilepsy, Frontal Lobe/*chemically induced/diagnosis
MH  - Humans
MH  - Male
MH  - Nipecotic Acids/*adverse effects/therapeutic use
MH  - Status Epilepticus/*chemically induced/diagnosis
MH  - Tiagabine
EDAT- 2000/11/15 11:00
MHDA- 2001/02/28 10:01
CRDT- 2000/11/15 11:00
PHST- 2000/11/15 11:00 [pubmed]
PHST- 2001/02/28 10:01 [medline]
PHST- 2000/11/15 11:00 [entrez]
AID - 10.1111/j.1528-1157.2000.tb00126.x [doi]
PST - ppublish
SO  - Epilepsia. 2000 Nov;41(11):1485-8. doi: 10.1111/j.1528-1157.2000.tb00126.x.