Chen Richard J, Ershad Muhammad, Dela Cruz Maricel, Mostafa Ahmed Mamdouh Taha
Drexel University College of Medicine, Department of Emergency Medicine, Division of Medical Toxicology, Philadelphia, PA, USA.
Case Rep Emerg Med. 2020 Mar 16;2020:1790310. doi: 10.1155/2020/1790310. eCollection 2020.
Carbamazepine is an antiepileptic drug that can cause seizures in overdose. In certain patient populations, this may be misdiagnosed as a seizure disorder. We describe a case of a 20-month-old female who presented with fever and seizure-like activity who was initially thought to have complex febrile seizures. Further historical information prompted carbamazepine level to be checked, which was found to be 29 mcg/ml (therapeutic range of 4-12 mcg/ml). Her carbamazepine levels downtrended with multidose activated charcoal. Her condition improved, and she was discharged without evidence of permanent neurologic sequelae. This case illustrates that xenobiotic exposure should often be considered, even if historical clues are not present, as they can often present as other conditions leading to misdiagnosis and delayed treatment.
卡马西平是一种抗癫痫药物，过量服用时可导致癫痫发作。在某些患者群体中，这可能会被误诊为癫痫障碍。我们描述了一例20个月大的女性病例，她出现发热和类似癫痫的活动，最初被认为患有复杂性热性惊厥。进一步的病史信息促使对卡马西平水平进行检查，结果发现其水平为29微克/毫升（治疗范围为4 - 12微克/毫升）。通过多次给予活性炭，她的卡马西平水平下降。她的病情有所改善，出院时没有永久性神经后遗症的迹象。该病例表明，即使没有病史线索，也应经常考虑外源性物质暴露，因为它们常常表现为其他导致误诊和治疗延误的病症。
