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[Seizures during interferon alpha therapy: three cases in dermatology]
E Legroux-Crespel1, S Lafaye, E Mahé
1Service de Dermatologie, Groupe Hospitalier Bichat-Claude Bernard, Paris.
Introduction:
Interferon alpha has many side effects. Among them the risk of occurrence of seizures is not well known by dermatologists. We report three cases of seizures that occurred in patients treated with interferon alpha in two dermatological diseases: mycosis fungoides and melanoma.
Observations:
A 68 year-old man, treated for mycosis fungoides, and two men aged 47 and 52 years, treated for melanoma, were under interferon alpha. After 11 months, 3 weeks and 9.5 months, respectively, the three patients had seizures without any past history of epilepsy. Anamnesis and assessment of each patient (brain CT, biological results) suggested the responsibility of interferon alpha. After withdrawal of the treatment, no relapse was observed after 3 months, 6 months and 1 year later, respectively.
Discussion:
Seizures during treatment with interferon alpha have already been reported. According to the series their prevalence would be of 1 to 4 p. 100. Their pathophysiology is not well known, but apparently interferon alpha lowers the epileptogenic threshold by affecting the central nervous system either directly or through cytokines or neuromediators. The risk of occurrence of seizures must be known by the prescribing physician who must systematically search for past history of epilepsy or risk factors for seizures. This rare but existing side effect raises the problem of information to be supplied to the patient by the prescribing physician.
Insights
Interferon alpha, used for mycosis fungoides and melanoma, can cause seizures. Dermatologists should be aware of this rare side effect and assess patients for epilepsy risk factors.
Area of Science:
- Dermatology
- Neurology
- Pharmacology
Background:
- Interferon alpha is a treatment for various conditions, including mycosis fungoides and melanoma.
- Seizures are a known but not widely recognized side effect of interferon alpha therapy.
- Dermatologists may not be fully aware of the risk of seizures associated with interferon alpha.
Observation:
- Three male patients treated with interferon alpha for mycosis fungoides and melanoma developed seizures.
- Seizures occurred after 3 weeks to 11 months of treatment.
- No prior history of epilepsy was noted in these patients.
Findings:
- Medical assessments, including brain CT and biological results, suggested interferon alpha as the cause of seizures.
- Discontinuation of interferon alpha led to no seizure recurrence in the observed follow-up periods (3 months to 1 year).
Implications:
- Interferon alpha may lower the epileptogenic threshold, potentially through central nervous system effects.
- Physicians prescribing interferon alpha must inquire about epilepsy history and risk factors.
- Patients should be informed about the potential risk of seizures, a rare but significant side effect.
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