Briassoulis G, Kalabalikis P, Tamiolaki M, Hatzis T
Pediatric Intensive Care Unit, Aghia Sophia Children's Hospital, Athens, Greece.
Pediatr Neurol. 1998 Sep;19(3):239-42. doi: 10.1016/s0887-8994(98)00050-2.
A 2-year-old male developed generalized tonic-clonic seizure activity, tremor of limbs, muscle weakness, ataxia, and hypertonia after he swallowed 16 50-mg tablets of lamotrigine. His vital signs were normal, as were electroencephalography and laboratory investigation tests. The urine toxicologic screen revealed no other drugs. Treatment included midazolam and gastric lavage followed by activated charcoal and fluid loads. Symptoms resolved within 24 hours, and the child was discharged without any further complications. Serial blood samples revealed plasma lamotrigine levels at the high adult therapeutic range (3.8 mg/L) but a slow elimination rate. This is the first report of seizure activity reported in a patient receiving an overdose of lamotrigine. However, no evident concentration-effect-side-effect relationship has been established in children. Interestingly in this child, lamotrigine overdose presented exclusively with treatment-emergent neurologic abnormalities, sparing all other systems.
一名2岁男性在吞服16片50毫克的拉莫三嗪后出现全身性强直阵挛性癫痫活动、肢体震颤、肌肉无力、共济失调和张力亢进。他的生命体征正常，脑电图和实验室检查结果也正常。尿液毒理学筛查未发现其他药物。治疗包括咪达唑仑和洗胃，随后给予活性炭和大量补液。症状在24小时内缓解，患儿出院，无任何进一步并发症。连续血样显示血浆拉莫三嗪水平处于成人治疗高范围（3.8毫克/升），但消除率缓慢。这是首例关于过量服用拉莫三嗪患者出现癫痫活动的报告。然而，在儿童中尚未建立明显的浓度-效应-副作用关系。有趣的是，该患儿过量服用拉莫三嗪仅表现为治疗中出现的神经异常，其他所有系统均未受累。
