Antihistamines as a common cause of new-onset seizures: a single-center observational study

Kim, Hayom; Kim, Seong Hwan; Kim, Ho Jin

doi:10.1007/s10072-021-05043-2

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…This study was based on analyses of long-term video-EEG monitoring data acquired from January 2018 to December 2021 in Korea University Anam Hospital and was an extension of our previous work 6 . We selected data from the database, an archive of EEG raw data acquired at the Clinical Neurophysiology Laboratory of Korea University Anam Hospital, of patients who had completed comprehensive tests for the differential diagnosis of new-onset seizures.…”

Section: Methodsmentioning

confidence: 99%

“…A recent observational study reported that antihistamines accounted for the greatest proportion of drug-induced ASSs 6 . Because antihistamines are commonly used as over-the-counter medications for treating the common cold, allergic rhinitis, dermatitis, and urticaria, as well as for relieving symptoms of coronavirus infectious disease 2019 around the world, antihistamines should be investigated as a potential cause of new-onset ASSs.…”

Section: Introductionmentioning

confidence: 99%

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Inherent seizure susceptibility in patients with antihistamine-induced acute symptomatic seizure: a resting-state EEG analysis

Kim

Wang

Park

et al. 2023

Sci Rep

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We compared neural activities and network properties between the antihistamine-induced seizures (AIS) and seizure-free groups, with the hypothesis that patients with AIS might have inherently increased neural activities and network properties that are easily synchronized. Resting-state electroencephalography (EEG) data were collected from 27 AIS patients and 30 healthy adults who had never had a seizure. Power spectral density analysis was used to compare neural activities in each localized region. Functional connectivity (FC) was measured using coherence, and graph theoretical analyses were performed to compare network properties between the groups. Machine learning algorithms were applied using measurements found to be different between the groups in the EEG analyses as input features. Compared with the seizure-free group, the AIS group showed a higher spectral power in the entire regions of the delta, theta, and beta bands, as well as in the frontal areas of the alpha band. The AIS group had a higher overall FC strength, as well as a shorter characteristic path length in the theta band and higher global efficiency, local efficiency, and clustering coefficient in the beta band than the seizure-free group. The Support Vector Machine, k-Nearest Neighbor, and Random Forest models distinguished the AIS group from the seizure-free group with a high accuracy of more than 99%. The AIS group had seizure susceptibility considering both regional neural activities and functional network properties. Our findings provide insights into the underlying pathophysiological mechanisms of AIS and may be useful for the differential diagnosis of new-onset seizures in the clinical setting.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Inherent seizure susceptibility in patients with antihistamine-induced acute symptomatic seizure: a resting-state EEG analysis

Kim

Wang

Park

et al. 2023

Sci Rep

Self Cite

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“…However, breakthrough seizures in patients with IGE are often GTCS. A missed medication dose, sleep deprivation, excess alcohol intake, or over-the-counter (e.g., diphenhydramine, pseudoephedrine) 2 , 3 or prescribed (e.g., bupropion and tramadol) medications can cause greater morbidity and mortality than in focal epilepsy, where breakthrough seizures are often nonconvulsive. Counseling should emphasize medication adherence and lifestyle factors, especially challenging in adolescents and young adults.…”

Section: History and Backgroundmentioning

confidence: 99%

Idiopathic Generalized Epilepsy

Devinsky,

Elder,

Sivathamboo

et al. 2024

Neurology

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The idiopathic generalized epilepsies (IGE) make up a fifth of all epilepsies, but <1% of epilepsy research. This skew reflects misperceptions: diagnosis is straightforward, pathophysiology is understood, seizures are easily controlled, epilepsy is outgrown, morbidity and mortality are low, and surgical interventions are impossible. Emerging evidence reveals that patients with IGE may go undiagnosed or misdiagnosed with focal epilepsy if EEG or semiology have asymmetric or focal features. Genetic, electrophysiologic, and neuroimaging studies provide insights into pathophysiology, including overlaps and differences from focal epilepsies. IGE can begin in adulthood and patients have chronic and drug-resistant seizures. Neuromodulatory interventions for drug-resistant IGE are emerging. Rates of psychiatric and other comorbidities, including sudden unexpected death in epilepsy, parallel those in focal epilepsy. IGE is an understudied spectrum for which our diagnostic sensitivity and specificity, scientific understanding, and therapies remain inadequate.

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“…Caution is similarly followed when using supratherapeutic doses, and combinations of sedating and nonsedating antihistamines as overdose can lead to drowsiness, blurred vision, nausea, vomiting, increased heart rate, confusion, loss of balance/dizziness, drowsiness, headache, and agitation, and in rare instances frank hallucinations or pseudoseizures. [58][59][60][61] These untoward adverse effects can particularly complicate the clinical evaluation and treatment of symptomatic individuals with HaT because these symptoms are perceived to overlap with those frequently associated with HaT. Caution is further warranted when prescribing courses of systemic corticosteroids, and an inventory should be made of the frequency and cumulative doses received from various providers because many patients receive regular courses of steroids after anaphylactoid or anaphylactic reactions-particularly from emergency departmentsand the harm profile of steroids is well established even with shortterm use (<30 days in a 12-month period).…”

Section: Management Strategies In Symptomatic Individuals With Heredi...mentioning

confidence: 99%

Clinical relevance of inherited genetic differences in human tryptases

Glover

Carter

Korošec

et al. 2021

Annals of Allergy, Asthma & Immunology

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Antihistamines as a common cause of new-onset seizures: a single-center observational study

Cited by 6 publications

References 10 publications

Inherent seizure susceptibility in patients with antihistamine-induced acute symptomatic seizure: a resting-state EEG analysis

Inherent seizure susceptibility in patients with antihistamine-induced acute symptomatic seizure: a resting-state EEG analysis

Idiopathic Generalized Epilepsy

Clinical relevance of inherited genetic differences in human tryptases

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