Illán-Gala Ignacio, Díaz de Terán Francisco Javier, Alonso Pablo, Aguilar-Amat María-José
Department of Neurology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Spain.
Department of Neurology, Hospital Universitario La Paz, Universidad Autónoma de Madrid, Spain ; Reference Unit of Refractory Epilepsy, Spain.
Epilepsy Behav Case Rep. 2015 Jun 5;4:20-2. doi: 10.1016/j.ebcr.2014.12.001. eCollection 2015.
Nonconvulsive status epilepticus (NCSE) can be triggered by metabolic disturbances and drugs in adults without previous epilepsy. We present the case of a 51-year-old woman without previous history of epilepsy and recently diagnosed with infiltrating lobular breast carcinoma. Following the administration of paclitaxel-cremophor, she presented a striking disinhibited behavior with episodic spatial disorientation, emotional indifference, and irritability. Urgent EEG was consistent with NCSE. Clinical improvement and resolution of EEG abnormalities were observed following the administration of intravenous levetiracetam and lacosamide. Other causes of NCSE were ruled out, and antiepileptic drugs were slowly tapered off without new episodes of abnormal behavior after three months of follow-up. We have reported the first case of NCSE secondary to paclitaxel-cremophor. Neurologists and oncologists should consider NCSE as an unusual complication of treatment with paclitaxel-cremophor in patients without a history of epilepsy.
非惊厥性癫痫持续状态（NCSE）可由代谢紊乱和药物引发，发生于既往无癫痫病史的成年人。我们报告了一名51岁女性病例，该患者既往无癫痫病史，近期被诊断为浸润性小叶乳腺癌。在使用紫杉醇-聚氧乙烯蓖麻油后，她出现了明显的去抑制行为，伴有发作性空间定向障碍、情感淡漠和易怒。紧急脑电图检查结果符合NCSE。静脉注射左乙拉西坦和拉科酰胺后，临床症状改善，脑电图异常消失。排除了NCSE的其他病因，在随访三个月后，抗癫痫药物逐渐减量，未再出现异常行为发作。我们报道了首例继发于紫杉醇-聚氧乙烯蓖麻油的NCSE病例。神经科医生和肿瘤科医生应将NCSE视为无癫痫病史患者接受紫杉醇-聚氧乙烯蓖麻油治疗时的一种罕见并发症。
