一名中枢性尿崩症患者因服用左乙拉西坦和止痛药诱发低钠血症性癫痫发作
Hyponatremia-Induced Epileptic Seizure Provoked by Levetiracetam and Pain Medication Intake in a Patient with Central Diabetes Insipidus.
作者信息
Nägele Herbert, Rosenkranz Michael, Nägele Matthias P
机构信息
Albertinen Hospital, Hamburg, Hamburg, Germany.
Department of Cardiology, University Hospital Zurich, Zurich, Switzerland.
出版信息
Case Rep Neurol. 2024 Jul 22;16(1):204-207. doi: 10.1159/000540320. eCollection 2024 Jan-Dec.
INTRODUCTION
Causes of epileptic seizures are often multifactorial but for an effective therapy, they should be uncovered in detail.
CASE PRESENTATION
We present a 67-year-old male patient with a central diabetes insipidus, who experienced a generalized tonic-clonic seizure. The patient was treated with levetiracetam for prevention of further seizures, opioids and non-steroidal anti-inflammatory drugs, i.e., ibuprofen because of severe back pain due to vertebral compression fractures. In this setting, he developed significant hyponatremia and experienced another epileptic seizure. After stopping analgesics and switching from levetiracetam to lacosamide, sodium levels returned to normal and the patient remained free of seizures since then.
CONCLUSION
The interrelationships of medical therapy, sodium levels and epileptic seizures in the context of central diabetes insipidus are discussed.
引言
癫痫发作的原因通常是多因素的，但为了进行有效的治疗，应详细查明这些原因。
病例介绍
我们报告一名67岁患有中枢性尿崩症的男性患者，他经历了一次全身性强直阵挛发作。该患者接受左乙拉西坦治疗以预防进一步发作，因椎体压缩性骨折导致严重背痛而使用了阿片类药物和非甾体抗炎药，即布洛芬。在此情况下，他出现了明显的低钠血症并再次发生癫痫发作。停用镇痛药并将左乙拉西坦换为拉科酰胺后，钠水平恢复正常，此后患者未再发作。
结论
讨论了中枢性尿崩症背景下药物治疗、钠水平和癫痫发作之间的相互关系。
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