1/3. stupor from lamotrigine toxicity.PURPOSE: To report that acute lamotrigine poisoning may result in severe encephalopathy. methods: A 55-year-old woman became stuporous after overdose with lamotrigine (LTG) and valproic acid (VPA) tablets. Evaluation revealed elevated serum LTG levels and no other etiology for encephalopathy. RESULTS: LTG was withheld, and the patient experienced a complete recovery in conjunction with reduced serum levels. CONCLUSIONS: LTG overdose may result in a severe but reversible encephalopathy, a previously undescribed phenomenon. LTG toxicity should be considered in patients taking this drug who have depressed mental status.- - - - - - - - - - ranking = 1keywords = stupor (Clic here for more details about this article) |
2/3. Drug induced encephalopathy in six epileptic patients: topiramate? valproate? or both?Six severe epileptic patients developed stuporous encephalopathy with marked cognitive impairment when topiramate (TPM) and sodium valproate (VPA) were coprescribed for five patients, and when monotherapy with TPM was introduced for one patient. In four patients, ammonaemia increased and then returned to normal after TPM or VPA withdrawal. This severe potential side effect must be recognized. Moreover two distinct mechanisms might explain this toxicity: (1). a pharmacokinetic interaction between VPA and TPM, leading to hyperammonaemia, (2). a pharmacodynamic mechanism due to a direct toxicity of TPM in at-risk epileptic patients.- - - - - - - - - - ranking = 1keywords = stupor (Clic here for more details about this article) |
3/3. pica with paradichlorobenzene mothball ingestion associated with toxic leukoencephalopathy.This is a case report of central nervous system toxicity associated with paradichlorobenzene (PDCB) ingestion. The patient had ingested mothballs composed of 99.99% PDCB for a period of 7 months. She was admitted for depression and had no neurologic symptoms. Later she developed an acute cerebellar syndrome followed by stupor and coma. An extensive workup was negative except for decreasing levels of PDCB in her serum. Imaging revealed a diffuse leukoencephalopathy. Her clinical picture was attributed to PDCB toxicity.- - - - - - - - - - ranking = 1keywords = stupor (Clic here for more details about this article) |