Zhang Lili, Yang Pingping, Zhu Ying, Liu Kexin, Sun Zhanxue
Beijing University of Chinese Medicine Third Affiliated Hospital, 51 Xiaoguan Street, Andingmen Outer Street, Chaoyang District, Beijing, 100029, China.
Beijing Chaoyang Xiangheyuan Community Health Service Center, Beijing, China.
BMC Womens Health. 2025 Jul 28;25(1):371. doi: 10.1186/s12905-025-03796-y.
Lamotrigine is a preferred antiepileptic drug for women with epilepsy planning or undergoing pregnancy, owing to its relatively low teratogenic risk. However, serious adverse reactions, including life-threatening conditions such as Stevens-Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TEN), can occur.
We report the case of a 33-year-old woman of childbearing age with epilepsy who developed TEN following the initiation of lamotrigine as part of a preconception antiepileptic regimen. The patient presented with high fever, a rapidly spreading erythematous rash, bullae formation, and extensive epidermal detachment. Prompt and comprehensive multidisciplinary treatment led to significant clinical improvement and eventual full recovery. The therapeutic approach included intravenous dexamethasone sodium phosphate, fluid resuscitation, intravenous immunoglobulin (IVIG), oral antihistamines, traditional Chinese medicine (TCM), and meticulous care of the skin and mucosal surfaces.
While antiepileptic drugs (AEDs) such as lamotrigine are crucial for managing epilepsy, they may induce severe skin toxicity, potentially leading to fatal outcomes. Healthcare providers must remain vigilant for early symptoms and intervene promptly to mitigate adverse effects. This case report, alongside a literature review, aims to underscore the importance of comprehensive care throughout the preconception, pregnancy, and postpartum phases for women with epilepsy.
拉莫三嗪因其相对较低的致畸风险，是计划怀孕或正在怀孕的癫痫女性的首选抗癫痫药物。然而，可能会出现严重的不良反应，包括危及生命的情况，如史蒂文斯-约翰逊综合征（SJS）和中毒性表皮坏死松解症（TEN）。
我们报告了一例33岁育龄癫痫女性的病例，该患者在开始将拉莫三嗪作为孕前抗癫痫治疗方案的一部分后发生了TEN。患者出现高热、迅速蔓延的红斑皮疹、水疱形成和广泛的表皮脱落。及时且全面的多学科治疗使临床症状得到显著改善并最终完全康复。治疗方法包括静脉注射地塞米松磷酸钠、液体复苏、静脉注射免疫球蛋白（IVIG）、口服抗组胺药、中药（TCM）以及精心护理皮肤和黏膜表面。
虽然拉莫三嗪等抗癫痫药物（AEDs）对控制癫痫至关重要，但它们可能会诱发严重的皮肤毒性，有可能导致致命后果。医疗保健提供者必须对早期症状保持警惕并及时干预以减轻不良反应。本病例报告以及文献综述旨在强调癫痫女性在孕前、孕期和产后阶段进行全面护理的重要性。
