Lahmek Pierre, Michel Laurent, Meunier Nadine, Aubin Henri-Jean
Centre de Traitement des Addictions, Hôpital Emile Roux, Assistance Publique-Hôpitaux de Paris, 94450 Limeil-Brévannes, France.
Case Rep Med. 2009;2009:705635. doi: 10.1155/2009/705635. Epub 2010 Jan 24.
Objective. To report one case of seizure following administration of ofloxacin. Case Summary. A 38-year-old woman with alcohol dependence but no prior history of seizure disorder admitted in our inpatient alcohol detoxification program was prescribed ofloxacin four days after admission for a lower urinary tract infection. She was currently prescribed diazepam 30 mg per day. This treatment was continued without modification following admission. Forty eight hours after starting ofloxacin and after receiving five doses of oral ofloxacin, the patient experienced a seizure. Ofloxacin treatment was stopped and no further seizures occurred. Neurological examination of the patient, laboratory tests, computerized tomography with contrast enhancement and electroencephalography did not detect any abnormalities. Up to the last consultation, six months after admission, the patient has reported no recurrence of the seizure. Discussion. Quinolone antibiotics vary in their ability to induce seizures, with ofloxacin having one of the least potentials. In the present case, the seizure could be attributed in all probability to taking ofloxacin; since she had no previous history of seizures, she did not present an alcohol withdrawal syndrome, benzodiazepine treatment was not modified, the seizure occurred 48 h after taking ofloxacin, but seven days after stopping drinking, no alternative aetiologies for the seizure could be identified and no seizure recurrence was reported over the following seven months. Of reported cases of seizures in patients treated with fluoroquinolones, none concerned patients with alcohol dependence or patients treated with benzodiazepines. Conclusions. The present case alerts us to the possibility that seizures may occur in alcohol dependent patients treated with benzodiazepines who concomitantly prescribed a fluoroquinolone. These widely-used antibiotics should thus be prescribed with caution to patients undergoing detoxification for alcohol dependence, particularly if they are also taking benzodiazepines, irrespective of whether they have a previous history of seizures or not.
目的。报告1例服用氧氟沙星后发生癫痫发作的病例。病例摘要。一名38岁酒精依赖女性，既往无癫痫病史，因酒精戒断入住我院住院治疗项目。入院4天后因下尿路感染给予氧氟沙星治疗。她目前每天服用30毫克地西泮。入院后该治疗持续未变。开始服用氧氟沙星48小时后，在接受5剂口服氧氟沙星后，患者发生癫痫发作。停用氧氟沙星治疗，未再发生癫痫发作。对患者进行神经系统检查、实验室检查、增强计算机断层扫描和脑电图检查均未发现任何异常。截至入院6个月后的最后一次会诊，患者未再出现癫痫复发。讨论。喹诺酮类抗生素诱发癫痫的能力各不相同，氧氟沙星诱发癫痫的可能性最小。在本病例中，癫痫发作很可能归因于服用氧氟沙星；由于她既往无癫痫病史，未出现酒精戒断综合征，苯二氮䓬类药物治疗未改变，癫痫发作发生在服用氧氟沙星48小时后，但戒酒7天后，未发现癫痫发作的其他病因，且在随后7个月内未报告癫痫复发。在报道的接受氟喹诺酮类药物治疗的患者癫痫发作病例中，无一涉及酒精依赖患者或接受苯二氮䓬类药物治疗的患者。结论。本病例提醒我们，在接受苯二氮䓬类药物治疗且同时服用氟喹诺酮类药物的酒精依赖患者中可能会发生癫痫发作。因此，对于正在接受酒精依赖戒断治疗的患者，尤其是同时服用苯二氮䓬类药物的患者，无论他们既往是否有癫痫病史，使用这些广泛使用的抗生素时都应谨慎。
