过量奥卡西平致定向力障碍及共济失调

1例6岁男性癫痫患儿,曾先后口服苯妥英钠、拉莫三嗪、丙戊酸钠、苯巴比妥治疗,因不能规律服药致使癫痫反复发作且进行性加重,家属自行给予其口服奥卡西平300 mg、3次/d,上述症状未再发作。但40 d后出现行走不稳、反应迟钝,且癫痫症状也加重。入院诊断为癫痫,全身强直-阵挛发作,奥卡西平致定向力障碍及共济失调。停用奥卡西平,给予丙戊酸钠、还原性谷胱甘肽、维生素C,次日癫痫得到控制。第8天定向力障碍及共济失调消失,癫痫未再发作,遂出院。出院后规律服用丙戊酸钠和氯硝西泮。随访1个月,未再出现癫痫发作、定向力障碍和共济失调。

Disorientation and ataxia following an overdose of oxcarbazepine

A 6-year-old male child with epilepsy had received oral phenytoin sodium, lamotrigine, sodium valproate, and phenobarbital. Because of his irregular use of the drugs, he developed repeated epileptic seizures which progressively worsened. His parents gave him oral oxcarbazepine 300 mg thrice daily themselves and the above-mentioned symptoms did not reappear. However, 40 days later, he experienced unstable walking and torpid response, and his epilepsy symptoms became aggravated. The patient was diagnosed with epilepsy, generalized tonic-clonic seizure, oxcarbazepine-induced disorientation, and ataxia on admission. Oxcarbazepine was stopped, and sodium valproate, reduced glutathione, and vitamin C were given. The next day, his epilepsy symptoms were controlled and, on day 8, his disorientation and ataxia resolved. So he was discharged. He received regularly sodium valproate and clonazepam after discharge and epilepsy seizure, disorientation, and ataxia did not recur at one-month follow-up.