Baylor College of Medicine, United States.
Baylor College of Medicine, Department of Otolaryngology - Head and Neck Surgery, United States.
Int J Pediatr Otorhinolaryngol. 2021 Jan;140:110498. doi: 10.1016/j.ijporl.2020.110498. Epub 2020 Nov 15.
Acute macroglossia and laryngeal edema are rare adverse side effects that can cause life-threatening airway obstruction. We report a case of acute macroglossia that began after initiation of ethosuximide in a 15-year-old female with severe medically refractory epilepsy. Macroglossia worsened over the next two weeks of ethosuximide administration, preventing extubation. Macroglossia and laryngeal edema improved upon ethosuximide wean, and completely resolved after discontinuation. The patient was extubated successfully, with precautionary nasal trumpet placement and dexamethasone administration prior to extubation. In medically complex patients on multiple pharmacologic agents, anti-epileptic drugs should be suspected as a possible cause of acute macroglossia.
急性巨舌症和喉水肿是罕见的不良反应，可导致危及生命的气道阻塞。我们报告了一例在 15 岁患有严重药物难治性癫痫的女性中开始使用乙琥胺后发生的急性巨舌症。在乙琥胺给药的接下来两周内，巨舌症恶化，导致无法拔管。在停用乙琥胺后，巨舌症和喉水肿改善，并完全消退。在成功拔管前，对接受多种药物治疗的复杂医学患者，应预防性使用鼻管并给予地塞米松。在接受多种药物治疗的复杂医学患者中，抗癫痫药物应被怀疑是急性巨舌症的可能原因。
