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• W1422126190 abstract "This chapter examines the case of a patient suffering from MRI negative refractory partial epilepsy with rapid secondary generalization and Stevens–Johnson syndrome secondary to lamotrigine. A 23-year-old right-handed man first presented at age 21 years with generalized tonic–clonic seizures lasting for about 4–5 min. These occurred without warning, and resulted in minor injury on several occasions. Despite sodium valproate, he continued to have seizures at least once a month. Lamotrigine was added, starting at 25 mg/day increased to 50 mg/day after 2 weeks, a higher starting dose than recommended in the data sheet as add-on treatment to valproate. Unfortunately, this led to Stevens–Johnson syndrome requiring hospitalization. The patient later recalled being warned about the possibility of a rash but not of mouth ulcers, this resulting in some delay in presentation. Lamotrigine was stopped with full recovery. EEG showed focal epileptiform activity with frequent sharp waves and sharpened slow waves over the right temporal electrodes in the awake EEG and runs of focal polyspikes lasting 1–3 s in a right frontotemporal distribution during sleep. On slow release carbamazepine 400 mg twice/day, seizure frequency improved from once a week to one nocturnal seizure in the last 6 months with no further daytime seizures. He has been able to take up employment again. Assessment for possible epilepsy surgery has been put on hold. The epilepsy history in this case is suggestive of an underlying cortical dysplasia with unprovoked relatively frequent seizures presenting at the age of 21. There was frequent focal epileptiform activity on EEG. MRI was normal as is the case in about 30% of patients with cortical dysplasia." @default.
• W1422126190 created "2016-06-24" @default.
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• W1422126190 date "2008-01-01" @default.
• W1422126190 modified "2023-10-18" @default.
• W1422126190 title "Should He or Shouldnt't He? Is It Reasonable to Prescribe Carbamazepine after Lamotrigine-induced Stevens–Johnson Syndrome?" @default.
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• W1422126190 doi "https://doi.org/10.1016/b978-0-12-374005-2.00051-x" @default.
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