Daana Muhannad, Nevo Yoram, Tenenbaum Ariel, Taustein Illana, Berger Itai
Department of Pediatrics, Hadassah Hebrew University Medical Center, Jerusalem, Israel.
J Child Neurol. 2007 May;22(5):642-4. doi: 10.1177/0883073807302600.
The purpose of this article is to describe an unusual presentation of lamotrigine toxicity in an epileptic child treated on a lower than previously reported dosage. This is a case description of a 5-year-old epileptic girl on lamotrigine monotherapy, which caused toxicity. The child presented with ataxia, drowsiness, and acute confusion after ingesting 500 mg (25 mg/kg/d) in two 250-mg doses 12 hours apart. This was followed by vomiting and seizure exacerbation. Discontinuing lamotrigine, intravenous fluids and observation were the mainstays of therapy. Until now, the reported minimum dose of lamotrigine causing toxicity was 800 mg. In this patient, toxic manifestation occurred after the initial 250 mg. This case report demonstrates the low safety margin in children treated with lamotrigine.
本文的目的是描述一名接受低于先前报道剂量治疗的癫痫儿童中拉莫三嗪毒性的异常表现。这是一例关于一名5岁癫痫女童接受拉莫三嗪单药治疗导致毒性反应的病例描述。该患儿在间隔12小时分两次各服用250mg（25mg/kg/d）共500mg后，出现共济失调、嗜睡和急性意识模糊。随后出现呕吐和癫痫发作加剧。停用拉莫三嗪、静脉补液及观察是主要治疗措施。迄今为止，报道的引起毒性反应的拉莫三嗪最小剂量为800mg。在该患者中，最初服用250mg后就出现了毒性表现。本病例报告表明接受拉莫三嗪治疗的儿童安全范围较低。
