Cardenas Javier F, Rho Jong M, Ng Yu-tze
Division of Child Neurology, Barrow Neurological Institute and St. Joseph's Hospital & Medical Center, Phoenix, Arizona, USA.
J Child Neurol. 2010 Feb;25(2):182-7. doi: 10.1177/0883073809336874. Epub 2009 Jun 3.
A retrospective review was performed in patients who developed neurobehavioral adverse reactions to lamotrigine. Data were obtained from interviews, examinations, and routine medical records. There were 7 male and 2 female patients with epilepsy with a mean age of 5 years. All 9 patients became hyperactive and agitated over a broad range of lamotrigine dosing (0.7-14.0 mg/kg per d). Five patients developed self-injurious and violent behaviors. Two patients developed severe insomnia. The most affected patient was a 6-year-old boy whose mood and affect became extremely volatile. He also experienced threatening visual and auditory hallucinations and insomnia. All 9 patients had dramatic improvement and/or resolution of the adverse neurobehavioral effects following discontinuation or reduction of lamotrigine. Reversible, severe neurobehavioral disturbances associated with lamotrigine therapy have not been reported in the literature. While idiosyncratic and uncommon, this is a potentially significant, clinical side effect. Further studies are necessary to clarify the population at risk.
对出现拉莫三嗪神经行为不良反应的患者进行了回顾性研究。数据来自访谈、检查和常规病历。有7名男性和2名女性癫痫患者，平均年龄为5岁。所有9名患者在广泛的拉莫三嗪给药剂量（每日0.7 - 14.0毫克/千克）范围内均出现多动和烦躁不安。5名患者出现自伤和暴力行为。2名患者出现严重失眠。受影响最严重的是一名6岁男孩，其情绪变得极度不稳定。他还经历了威胁性的视幻觉和听幻觉以及失眠。所有9名患者在停用或减少拉莫三嗪后，神经行为不良反应均有显著改善和/或消失。与拉莫三嗪治疗相关的可逆性、严重神经行为障碍在文献中尚未见报道。虽然这种情况特异且不常见，但这是一种潜在的重大临床副作用。有必要进行进一步研究以明确高危人群。
