Shehu Nathan Yakubu, Ojeh Victor, Osaigbovo Godwin, Agaba Patricia, Agbaji Oche
Jos University Teaching Hospital, Jos, Plateau State, Nigeria.
University of Jos, Jos, Plateau State, Nigeria.
J Med Case Rep. 2016 Apr 13;10:93. doi: 10.1186/s13256-016-0876-9.
Efavirenz is a commonly prescribed antiretroviral drug that is largely well tolerated. However, seizure disorder is a rare side effect. Prompt identification and immediate replacement of efavirenz with an alternative drug would effectively stop the seizures. To the best of our knowledge, we present the first reported case in the literature of complex partial seizures arising due to efavirenz.
We report a case of a 33-year-old Nigerian man treated with an efavirenz-based antiretroviral regimen for human immunodeficiency virus infection. He presented with seizures soon after commencement of antiretroviral drugs. His magnetic resonance imaging results were unremarkable. His blood levels of sodium, glucose, urea, and creatinine were within normal limits. However, his electroencephalogram showed intermittent bursts of high-voltage sharp waves and spikes bilaterally over frontotemporoparietal regions, a finding consistent with complex partial seizures. His efavirenz plasma level was 209.55 μg/ml. His seizures stopped following a switch to a non-efavirenz-based regimen.
This report brings to light the occurrence of complex partial seizures in patients on efavirenz. It also demonstrates the effective resolution of seizures when efavirenz treatment is replaced with a non-efavirenz-based regimen.
依非韦伦是一种常用的抗逆转录病毒药物，耐受性总体良好。然而，癫痫发作是一种罕见的副作用。迅速识别并立即用替代药物替换依非韦伦可有效终止癫痫发作。据我们所知，我们报告了文献中首例因依非韦伦引起的复杂部分性癫痫发作病例。
我们报告一例33岁尼日利亚男性，因人类免疫缺陷病毒感染接受基于依非韦伦的抗逆转录病毒治疗方案。在开始抗逆转录病毒药物治疗后不久，他出现了癫痫发作。他的磁共振成像结果无异常。他的血液中钠、葡萄糖、尿素和肌酐水平均在正常范围内。然而，他的脑电图显示双侧额颞顶叶区域间歇性出现高压尖波和棘波，这一发现与复杂部分性癫痫发作一致。他的依非韦伦血浆水平为209.55μg/ml。在改用非依非韦伦治疗方案后，他的癫痫发作停止了。
本报告揭示了接受依非韦伦治疗的患者中出现复杂部分性癫痫发作的情况。它还证明了用非依非韦伦治疗方案替代依非韦伦治疗时癫痫发作可有效缓解。
