Provocation of non-convulsive status epilepticus by tiagabine in three adolescent patients

Balslev, Thomas; Uldall, Peter; Buchholt, Jette

doi:10.1053/ejpn.2000.0293

Cited by 35 publications

(18 citation statements)

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“…They developed EEG findings, some associated with confusion and alteration of consciousness while others had minimal or no clinical findings. The clinical and EEG findings suggested discontinuation of the drug or decrease of the dose [13,14,15].…”

Section: Discussionmentioning

confidence: 99%

Seizures in a pediatric patient with a tiagabine overdose

2006

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Introduction: Tiagabine (TGB) is a novel antiepileptic that decreases GABA uptake. The literature contains one report of an adult with epilepsy who ingested up to 1 gram of TGB and developed status epilepticus. We reported on a pediatric patient who ingested significantly less TGB but still developed tonic-clonic seizures.Case report: A previously healthy, 13 kg, two-year-old girl developed generalized tonic-clonic seizure activity at home approximately 1 hour after ingesting 90 mg of her grandmother's TGB (forty five 2 mg tablets). At the hospital she had two 5 minute seizures at 1.5 and 3.5 hours post ingestion. Her serum TGB levels were 530 and 130 ng/ml approximately 5 and 11 hours post-ingestion (5-70 ng/ml trough levels with most probable range for seizure control). She was discharged 27 hours post ingestion, and she was in good condition.Conclusion: An overdose of TGB, a novel anti-epileptic, can cause convulsive seizures.

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Section: Discussionmentioning

confidence: 99%

Seizures in a pediatric patient with a tiagabine overdose

2006

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“…The major limitation of tiagabine is a propensity to cause non-convulsive status epilepticus which has been well-documented in many case reports and retrospective studies [152,153,154]. The mechanism of anti-convulsive action of tiagabine is not clear although inhibition of GABA reuptake has been proposed [22].…”

Section: Tiagabinementioning

confidence: 99%

Therapeutic Drug Monitoring of the Newer Anti-Epilepsy Medications

Krasowski

2010

Pharmaceuticals

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In the past twenty years, 14 new antiepileptic drugs have been approved for use in the United States and/or Europe. These drugs are eslicarbazepine acetate, felbamate, gabapentin, lacosamide, lamotrigine, levetiracetam, oxcarbazepine, pregabalin, rufinamide, stiripentol, tiagabine, topiramate, vigabatrin and zonisamide. In general, the clinical utility of therapeutic drug monitoring has not been established in clinical trials for these new anticonvulsants, and clear guidelines for drug monitoring have yet to be defined. The antiepileptic drugs with the strongest justifications for drug monitoring are lamotrigine, oxcarbazepine, stiripentol, and zonisamide. Stiripentol and tiagabine are strongly protein bound and are candidates for free drug monitoring. Therapeutic drug monitoring has lower utility for gabapentin, pregabalin, and vigabatrin. Measurement of salivary drug concentrations has potential utility for therapeutic drug monitoring of lamotrigine, levetiracetam, and topiramate. Therapeutic drug monitoring of the new antiepileptic drugs will be discussed in managing patients with epilepsy.

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“…Six articles were identified reporting 11 patients with partial epilepsy, with a focal lesion on neuroimaging, who had induction of NCSE following the introduction or increase in dose of tiagabine. 5,[7][8][9][10][11] …”

Section: Literature Reviewmentioning

confidence: 99%

“…Interestingly, NCSE was also seen in patients on low dose tiagabine alone, as with our case 1, and even in patients on low dose tiagabine in addition to enzyme inducing AEDs. 8,9 Most of the patients developed symptoms of NCSE shortly after dose escalation, rather than at drug commencement. 5,9,11 The NCSE resolved in all cases with either dose reduction or cessation of the drug, where a benzodiazepine was administered, prompt termination of the NCSE was uniformly seen, with the exception of case 2 in De Borchgrave et al 9 where intravenous diazepam had no appreciable effect clinically, but the NCSE resolved with dose reduction.…”

Section: Literature Reviewmentioning

confidence: 99%