Intensive Care Unit, Centre Hospitalier de Versailles-Site André Mignot, 78150, Le Chesnay, France.
Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Service de Réanimation Médicale, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France.
Acta Neurol Belg. 2020 Dec;120(6):1283-1288. doi: 10.1007/s13760-020-01464-6. Epub 2020 Aug 12.
Tiagabine-related status epilepticus (SE) is an uncommon complication of tiagabine use. We aimed to detail the features and outcomes in a patient with tiagabine poisoning and review the relevant literature. We describe a case of tiagabine-related SE and literature review based on a 1995-2019 PubMed search. We report the case of a 30-year-old man with super-refractory SE after tiagabine poisoning. He fully recovered after 72 h of general anesthesia and was discharged from the ICU on day 16. A literature review showed distinct features among patients with tiagabine-related SE. Tiagabine side effects were characterized by non-convulsive SE after a slight increase in tiagabine dose and a rapid favorable evolution after benzodiazepine and early tiagabine withdrawal. Generalized convulsive SE was a complication of voluntary or involuntary tiagabine poisoning and was particularly refractory. Both presentations are characterized by a return to baseline after prompt and adequate management. Tiagabine-related SE electroclinical features vary according to the underlying pathophysiological mechanism and can be life threatening. Recovery is the rule after tiagabine withdrawal and SE management with progressive therapeutic escalation guided by response to prior anticonvulsant treatments.
替加滨相关性癫痫持续状态（SE）是替加滨使用的一种罕见并发症。我们旨在详细描述一名替加滨中毒患者的特征和结局，并复习相关文献。我们描述了 1 例替加滨相关性 SE 病例，并基于 1995 年至 2019 年 PubMed 检索进行文献复习。我们报告了 1 例 30 岁男性患者，在替加滨中毒后发生超难治性 SE。他在全身麻醉 72 小时后完全恢复，并在第 16 天从 ICU 出院。文献复习显示，替加滨相关性 SE 患者具有明显特征。替加滨的副作用表现为轻微增加替加滨剂量后出现非惊厥性 SE，并在使用苯二氮䓬类药物和早期停用替加滨后迅速好转。全面性惊厥性 SE 是自愿或非自愿性替加滨中毒的并发症，且特别难治。这两种表现均在及时、充分治疗后恢复至基线水平。替加滨相关性 SE 的电临床特征根据潜在的病理生理机制而有所不同，可能危及生命。在替加滨停药和 SE 管理后，只要治疗方案逐步升级并根据之前抗癫痫治疗的反应进行调整，通常可以恢复。
