Anti-epileptic drugs-induced de novo absence seizures

Yang, Mei‐Sang; Lee, Wang-Tso; Chu, Li-Wen; Shen, Yu-Zen

doi:10.1016/s0387-7604(02)00120-1

Cited by 18 publications

(17 citation statements)

References 25 publications

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“…Patients with idiopathic epilepsies are most susceptible, whereas adult patients with partial‐onset seizure seem to be more immune to this effect . Children are different in this regard and should be followed with greater care to avoid seizure exacerbation or even the development of a new seizure type when least expected …”

Section: Seizure Exacerbationmentioning

confidence: 99%

Medical management of refractory epilepsy—Practical treatment with novel antiepileptic drugs

Ben‐Menachem

2014

Epilepsia

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SUMMARYThe ultimate treatment goal in epilepsy therapy is always freedom from seizures with as few treatment adverse effects as possible. If seizures persist with the first monotherapy, alternative monotherapy with another antiepileptic drug (AED) should be considered. Continuing seizures should lead to a reevaluation of differential diagnosis and adherence. Epilepsy surgery as an alternative therapy may be suitable in selected cases. If the diagnosis of epilepsy is established and epilepsy surgery is not appropriate, AED treatment should be optimized. Evidence for how to proceed is lacking. Concepts such as rational polytherapy have been advocated but remain speculative concerning better efficacy based on the use of AEDs with differing modes of action. A variety of new AEDs including rufinamide, lacosamide, vigabatrin, perampanel, and retigabine have been recently introduced in the United States. They are briefly characterized in this update review.

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Section: Seizure Exacerbationmentioning

confidence: 99%

Medical management of refractory epilepsy—Practical treatment with novel antiepileptic drugs

Ben‐Menachem

2014

Epilepsia

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“…CBZ may worsen absence seizures and may trigger status epilepticus in patients with absence epilepsy (22–28). It may also lead to new‐onset absences or be associated with the reappearance of absence seizures.…”

Section: Clinical Evidence For Aggravation Of Generalized Epilepsiesmentioning

confidence: 99%

Seizure Aggravation in Idiopathic Generalized Epilepsies

Chaves¹,

Sander²

2005

Epilepsia

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Summary: Seizures in the idiopathic generalized epilepsies (IGEs) usually remit completely with antiepileptic drugs (AEDs). Occasionally, however, they may be aggravated by AEDs. Before attributing exacerbation of seizures to an AED, alternative explanations need to be excluded. These include natural fluctuation of seizures, irregular compliance, maladjustment to the disease, comorbid illness, and development of tolerance. Aggravation may be due to a paradoxical reaction or drug‐induced encephalopathy, sedative effects, or inappropriate use of a drug; and this need to be established, as it will guide management. An important caveat is that most data on aggravation of generalized seizures are based on anecdotal case reports or case series. Whether considering efficacy or aggravation, the interpretation of data from uncontrolled studies and case reports must be treated with caution. In practice, despite the fact that clear evidence is lacking, the possibility of seizure aggravation must be considered when treating people with IGEs. Predictive factors for seizure aggravation in a particular patient with a specific drug are yet to be fully defined. It is paramount to classify seizure type correctly in all patients. If this is not possible, a broad‐spectrum AED should be used. Drugs that modulate Na+‐channels and GABAergic drugs seem to be more prone to aggravating seizures, and therefore are best avoided in the initial management of IGE. Further studies are required to elucidate this phenomenon in full. It is interesting to speculate that paradoxical responses to AEDs may have pharmacogenetic value, serving as tools for a more precise and useful characterization of the epilepsies.

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“…Carbamazepine aggravates absence seizure [10] which may account for the recurrence of panic attack after initiation of the drug in this patient. Meanwhile, several cases with panic attacks have been reported in whom the primary diagnosis was temporal lobe epilepsy [11].…”

Section: Discussionmentioning

confidence: 77%