Epileptic seizure after treatment with thiocolchicoside

Abstract

Background:Adverse drug reactions are important determinants of inpatient and outpatient morbidity. Thiocolchicoside is a semisynthetic derivate of naturally occurring colchicoside, which is largely used in humans as a centrally acting muscle relaxant. Epileptic seizures after thiocolchicoside intake have been reported in individuals with a history of epilepsy, acute brain injury or possible blood–brain barrier disruption.Case report:We report the case of a 66-year-old male patient presenting a sudden epileptic seizure temporally related to the intake of thiocolchicoside for muscle contracture and pain. The probably causes of the seizures were thiocolchicoside intake and cerebral microhemorrhages attributed to cerebral amyloid angiopathy.Discussion:Drugs only rarely cause focal seizures. Our case indicates that thiocolchicoside can precipitate seizures in predisposed patients, and that its use should be avoided in patients with brain diseases (and therefore lower seizure thresholds) or blood–brain barrier disruption. This information should be provided in the drug package insert.

Non convulsive refractory status epilepticus induced by thiocolchicoside (TCC) intrathecal injection: A case report

“…Several neurological side effects have been reported in association with TCC treatment including somnolence, confusion and seizure, the latter in a low percentage of patients. 3 However, a major epileptological complication, such as status epilepticus, has never been previously reported in association with TCC treatment. In the present report, we described a case of acute refractory NCSE in the context of a TCC‐induced acute toxic encephalopathy (ATE) in a woman without any previous neurological or physical comorbidities.…”

“…2 Even though the mechanism of action of TCC is not yet well understood, previous studies have suggested the interaction of this compound with a cortical subtype of the gamma-aminobutyric acid type A (GABA-A) receptor, inhibiting GABAergic transmission. 3 This peculiar mechanism could explain its pro-epileptogenic properties. In fact, TCC was described to reduce seizure threshold and cause convulsions in rat models.…”

Benzodiazepine partially reverses tonic-clonic seizures induced by thiocolchicoside

“…One of these studies showed TCC-induced seizure following disturbances of the blood-brain barrier (BBB), which indicates that TCC should be avoided in patients with BBB disruption (15). A second study reports a patient with a diagnosis of cerebral amyloid angiopathy, which disrupts the BBB, and the association with TCC treatment for muscle contracture and pain resulted in seizures (17). A third study involved a healthy 3-month-old patient who had a seizure after her mother had taken TCC while breastfeeding (16).…”

“…There are some case reports of TCC-induced seizures in human patients (15)(16)(17)(18). Specific experimental or clinical conditions proved that TCC could induce seizures especially in neurological patients with a history of epilepsy (12,15).…”

Determination colchicine content in aquadest-extracted Gloriosa superba seed from Sukoharjo and Gunung Kidul

“…It is chemically 2-demethoxy-2-glucosidoxythiocolchicine with a chemical formula C 27 H 33 NO 10 S. TCC has been used clinically for humans as a centrally acting muscle relaxant agent for the treatment of orthopedic, traumatic and rheumatological disorders [5]. This compound also has anti-inflammatory and analgesic effects [6]. It is an analogue of colchicines, since they share the same benzo(alpha) heptalenic moiety [7].…”