Tiagabine-induced non-convulsive status epilepticus in a patient without history of epilepsy

Cases of non-convulsive status epilepticus (NCSE) induced by tiagabine (TGB) were occasionally reported. Almost all had a prior history of epilepsy. We describe here, the clinical and EEG findings in a patient, without history of seizures, who after the start of TGB developed NCSE. A 53-year-old man with history of paranoid schizophrenia, presented with "alteration of his mental state." Three weeks early, TGB was added to his psychiatric regimen. On the second day of admission, he became unresponsive with a blank stare. Concomitant EEG showed abundant sharp and slow wave complexes. The episode lasted for 4 hours and was aborted by the intravenous administration of lorazepam. The TGB was discontinued without recurrence of subsequent seizure activity. This case supports the contention that TGB can induce NCSE in subjects not previously known to have seizures.