Topiramat Kullanımına Bağlı Negatif Myoklonus; Nadir Bir Olgu Sunumu

Öz

Epileptik negatif miyoklonus ENM çeşitli nörolojik hastalıklarla birlikte görülebilen spesifik olmayan epileptik özellikte motor bir bozukluktur. Öncesinde pozitif miyoklonusun izlenmediği, tonik kas aktivitesinin ani bir şekilde kesintiye uğramasıyla eş zamanlı olarak EEG’de epileptik anormal aktivitenin izlenmesi şeklinde tanımlanır. Epileptik negatif miyoklonus ENM ; çocukluk çağında sık görülen bening rolandik epilepsi gibi fokal epilepsilere eşlik edebildiği gibi, tedavide kulanılan antiepileptik ilaçlarla da ilişkili oluşabilmektedir. Sıklıkla karbamazepin kullanımına bağlı olarak bildirilmektedir, fakat okskarbazepin, fenitoin ve lamotrigin kullanımı sonrası da görülebilmektedir. Tedavide kullanılan antiepileptik ilaçların nöbet karakterini değiştirebildiği, bazen de nöbet sayı ve sıkılığını artırabildiği bilinmektedir. Bu yazıda, fokal motor nöbetleri sebebiyle takip edilen bir hastada; topiramat kullanımı sırasında gelişen epileptik negatif miyoklonustan bahsedilecektir

Anahtar Kelimeler

• Miyoklonus, Epileptik Negatif Miyoklonus, Topiramat

Negative Myoclonus Due to Topiramate Treatment: A Rare Case Presentation

Abstract

Epileptic negative myoclonus ENM is an unspecific motor disorder that can characterize a variety of neurological conditions. Epileptic negative myoclonus ENM is defined as an interruption of tonic muscle activity, which is time-locked to an epileptic EEG abnormality, without evidence of an antecedent positive myoclonia in the agonist–antagonist muscles. Some reports have demonstrated induction or worsening of ENM due to antiepileptic drugs in children suffering from focal epilepsies. Carbamazepine is the drug more frequently involved but other drugs such as oxcarbazepine, phenytoin and lamotrigine have been reported to be able to induce or aggravate ENM. It is well known that antiepileptic drugs may aggravate or precipitate seizures. This paradoxical reaction to a given antiepileptic drug is defined by the presence of increased seizure frequency or the appearance of new seizure types after its administration and full remission following its discontinuation. Here we present an epileptic child who had negative myoclonus after initiation of topiramate treatment

Keywords

• Myoclonus, Epileptic Negative Myoclonus, Topiramate

Kaynakça

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