Hakoun Abdullah M
Department of Neurology, Saint Louis University School of Medicine, St. Louis, USA.
Cureus. 2023 May 17;15(5):e39127. doi: 10.7759/cureus.39127. eCollection 2023 May.
Reported cases of topiramate ingestion resulting in coma and generalized convulsive status epilepticus are very rare. Such a phenomenon of a relatively safe antiepileptic drug (AED) causing serious neurological compromise should be carefully reviewed. A 39-year-old female with a history of uncontrolled epilepsy, migraine headaches, hypothyroidism, obsessive-convulsive disorder, and depression presented with generalized tonic-clonic seizures that progressed to status epilepticus and coma thereafter. She was intubated due to a depressed level of consciousness and transferred afterward to our hospital. Electroencephalography (EEG) demonstrated a burst suppression pattern without receiving any sedating agents. The level of consciousness improved on the fourth day, and she achieved complete neurological recovery by the sixth day of hospitalization. She was offered AEDs and supportive therapy during her admission. Upon further investigation into the cause of her seizures, it was discovered that she had ingested a large dose of topiramate in a suicide attempt.
据报道，服用托吡酯导致昏迷和全身惊厥性癫痫持续状态的病例非常罕见。一种相对安全的抗癫痫药物（AED）引发严重神经功能损害的这种现象应予以仔细审视。一名39岁女性，有癫痫控制不佳、偏头痛、甲状腺功能减退、强迫性惊厥障碍和抑郁症病史，出现全身强直阵挛性发作，随后进展为癫痫持续状态和昏迷。因意识水平降低而行气管插管，随后转至我院。脑电图（EEG）显示在未使用任何镇静剂的情况下出现爆发抑制模式。意识水平在第四天有所改善，住院第六天时神经功能完全恢复。她在住院期间接受了抗癫痫药物和支持性治疗。在进一步调查其癫痫发作原因时，发现她为自杀企图而服用了大剂量托吡酯。
