丙戊酸钠致脑损伤患者出现致死性肥胖

Lethal obesity associated with sodium valproate in a brain-injured patient.

作者信息

Black Deborah N, Althoff Robert R, Daye Kathleen, Pelletier Corinne A

机构信息

Department of Neurology, University of Vermont, Burlington, Vermont, USA.

出版信息

Cogn Behav Neurol. 2005 Jun;18(2):98-101. doi: 10.1097/01.wnn.0000152204.71409.2e.

DOI:10.1097/01.wnn.0000152204.71409.2e

PMID:15970728

Abstract

A 34-year-old man developed posttraumatic epilepsy and a disinhibited orbitofrontal syndrome following severe head trauma at age 22. After an 11-year prison term marked by repeated impulsive aggression, he was transferred to a state psychiatric hospital. Replacement of phenytoin by valproic acid resulted in a 100-lb weight gain, exacerbation of sleep apnea, and right heart failure. Despite replacement of valproate with topiramate, he died of a cardiorespiratory arrest during a seizure. This case illustrates the potential risks associated with valproate therapy in the obese brain-damaged population.

摘要

一名34岁男性在22岁时遭受严重头部创伤后患上创伤后癫痫和去抑制性眶额综合征。在经历了11年以反复冲动性攻击为特征的监禁期后，他被转至一家州立精神病医院。用丙戊酸替代苯妥英钠导致体重增加100磅、睡眠呼吸暂停加重以及右心衰竭。尽管用托吡酯替代了丙戊酸盐，但他在一次癫痫发作期间死于心肺骤停。该病例说明了丙戊酸盐治疗在肥胖脑损伤人群中存在的潜在风险。