Hamano Shin-ichiro, Mochizuki Mika, Morikawa Takeki
Division of Neurology, Saitama Children's Medical Center, Saitama, Japan.
Seizure. 2002 Apr;11(3):201-4. doi: 10.1053/seiz.2001.0568.
This report describes atypical absence seizures induced by phenobarbital (PB) in a patient with benign childhood epilepsy with centrotemporal spikes. An 11-year-old girl had nocturnal motor seizures, beginning at the age of 7 years. Interictal EEG displayed centrotemporal sharp waves in the left and right sides alternatively, which increased significantly in frequency during sleep. She was given a diagnosis of benign childhood epilepsy with centrotemporal spike and was treated with valproic acid (VPA), which controlled her seizures for 3 years. She experienced nocturnal Rolandic seizures again, at the age of 10 years 2 months, 10 years 10 months in spite of the regular medication, and PB 60 mg daily was added to the VPA. Her parents noted de novo a few seconds of unresponsive fits 7 days after PB administration. Ictal EEG of the fits revealed diffuse irregular spike and wave bursts (1-4 seconds). VPA and PB in her blood was within the therapeutic ranges. After discontinuing PB, the atypical absence seizures immediately disappeared. Phenobarbital should be added to the list of drugs that potentially provoke de novo seizures.
本报告描述了一名患有儿童良性癫痫伴中央颞区棘波的患者，因苯巴比妥（PB）诱发非典型失神发作。一名11岁女孩自7岁起出现夜间运动性发作。发作间期脑电图显示左右两侧中央颞区尖波交替出现，睡眠期间频率显著增加。她被诊断为儿童良性癫痫伴中央颞区棘波，并接受丙戊酸（VPA）治疗，癫痫发作得到控制达3年。尽管规律用药，她在10岁2个月、10岁10个月时再次出现夜间罗兰多癫痫发作，遂在VPA基础上加用每日60 mg苯巴比妥。其父母注意到服用PB 7天后出现了数秒的无反应发作。发作期脑电图显示弥漫性不规则棘波和慢波暴发（1 - 4秒）。她血液中的VPA和PB浓度在治疗范围内。停用PB后，非典型失神发作立即消失。苯巴比妥应被列入可能诱发新发癫痫发作的药物清单。
