Retrospective Analysis of Anticonvulsant Exposures Admitted to Department of Emergency Medicine in Dokuz Eylül University Hospital

Abstract

Purpose: To evaluate demographic characteristics, clinical signs and symptoms, treatment methods and clinical outcomes of anticonvulsant exposures in cases who were admitted to the Department of Emergency Medicine of in Dokuz Eylül University Hospital DEUH between 2000 and 2010 and reported to the Dokuz Eylül University Drug and Poison Information Center DEUDPIC .Methods: Age, sex, type of the anticonvulsant agents, route and causes of the exposure, clinical signs and symptoms, recommended and applied treatment methods and outcomes were recorded on a standard data forms, then entered into a computerized database program Ruber . The chi-square test was used in the statistical analyses. Results: Seventy seven patients 45 women, 32 men whose data were fully accessible were studied. Exposures were found to mostly occur due to acute 50.6% and intentional 77.9% . Patients presenting with anticonvulsant exposure, were most commonly admitted 32.5% to the DEUH within two hours after the ingestion. The most common causes of poisoning were identified as carbamazepine 32.5% and valproic acid 23.4% . On clinical evaluation, 36.4% of the patients did not develop any clinical signs or symptoms, and 7.8% of the patients developed severe clinical signs and symptoms. Most of the severe cases 66.7% resulted from carbamazepine ingestion. Also, 88.3% of the cases were found to have recovered and were discharged from the hospital without sequelae, no death occurred. The mean length of stay was 19.6±25.6 hours.Conclusion: Carbamazepine intoxication ranked first among the intoxications due to anticonvulsant exposures. In this case, the length of follow up in the emergency department may be prolonged, particularly as a result of the anticholinergic effects of carbamazepine that may delay the onset of clinical manifestations

Keywords

• Anticonvulsant,exposure,poisoning,emergency department,Drug and Poisoning Information Centre

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