Bernhard M K, Mütze U, Syrbe S
Universitätsklinik und Poliklinik für Kinder und Jugendliche, Leipzig.
Dtsch Med Wochenschr. 2013 Oct;138(42):2143-5. doi: 10.1055/s-0033-1349550. Epub 2013 Oct 8.
A 13-month-old girl suffered from 3 generalized tonic-clonic seizures for several minutes within a total period of 9 hours. History revealed that the child received a total of 5 dimenhydrinate containing suppositories à 40 mg during the previous 2 days (i. e. 23 mg dimenhydrinate per kg body weight) due to enteritis with vomiting. The first seizure occurred 10 hours after the last administration.
The plasma level of diphenhydramin was 230 µg/l approximately one hour after the first seizure. Electroencephalography showed no pathological signs, an MRI scan of the brain was normal except of several small gliotic spots and body temperature was regularly.
Two stationary occurring seizures were stopped with 5 mg diazepam rectally. Continued surveillance and an EEG two days later showed age-appropriate normal findings. There were no further seizures in the next 4 years.
Infants have the risk to develop dimenhydrinate intoxication, especially in cases where suppositories were given repeatedly because of intermittent defecation.
一名13个月大的女童在9小时内出现了3次全身性强直阵挛发作，每次发作持续数分钟。病史显示，该患儿因肠炎伴呕吐，在之前2天内共接受了5枚含40毫克茶苯海明的栓剂（即每公斤体重23毫克茶苯海明）。首次发作发生在最后一次用药后10小时。
首次发作后约1小时，血浆苯海拉明水平为230微克/升。脑电图未显示病理征象，脑部MRI扫描除有几个小的胶质斑外均正常，体温正常。
两次静止性发作通过直肠给予5毫克地西泮得以控制。持续监测，两天后的脑电图显示符合年龄的正常结果。在接下来的4年中未再出现发作。
婴儿有发生茶苯海明中毒的风险，尤其是因间歇性排便而反复使用栓剂的情况。
