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Epilepsy and comorbidity: infections and antimicrobials usage in relation to epilepsy management

J W Sander1, E Perucca

  • 1Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK. lsander@ion.ucl.ac.uk

Acta Neurologica Scandinavica. Supplementum
|September 27, 2003
PubMed

Insights

Infections are a major cause of epilepsy globally, particularly in developing nations. Certain antimicrobial drugs can trigger seizures and interact with antiepileptic drugs, necessitating careful prescribing.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pharmacology

Background:

  • Infections are the most common preventable cause of epilepsy worldwide.
  • Endemic infections like malaria and neurocysticercosis are linked to increased epilepsy incidence in developing countries.
  • Neurocysticercosis-associated epilepsy cases are rising in developed nations due to migration and travel.

Purpose of the Study:

  • To highlight the link between infections and epilepsy.
  • To discuss the implications of antimicrobial use in epilepsy patients.
  • To examine drug interactions between antimicrobials and antiepileptic drugs (AEDs).

Main Methods:

  • Literature review on infections and epilepsy.
  • Analysis of antimicrobial drug properties related to seizure activity.
  • Examination of pharmacokinetic interactions between antimicrobials and AEDs.

Main Results:

  • Certain antimicrobials (penicillins, cephalosporins, carbapenems, quinolones, antimalarials) possess proconvulsant activity.
  • These agents can precipitate seizures, even in non-epileptic individuals.
  • Many antimicrobials alter AED plasma levels, impacting treatment efficacy and safety.

Conclusions:

  • Careful consideration is required when prescribing antimicrobials to epilepsy patients.
  • Potential proconvulsant effects and drug interactions must be managed.
  • Optimizing antimicrobial selection and monitoring AED levels are crucial for patient safety.

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