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Oculogyric crisis induced by carbamazepine
1Department of Neurology, Henry Ford Hospital, Detroit, Michigan 48202, USA.
Epilepsia
|November 1, 1995
Summary
Carbamazepine (CBZ) may induce oculogyric crises (OGC) in patients with epilepsy, even when taking divalproex sodium (VPA). Reducing CBZ dosage resolved the upward gaze episodes, suggesting CBZ as the likely trigger.
Area of Science:
- Neurology
- Clinical Pharmacology
Background:
- Epilepsy management often involves multiple antiepileptic drugs.
- Complex partial seizures require careful medication management.
- Oculogyric crises (OGC) are rare adverse effects of some medications.
Observation:
- A patient with epilepsy on carbamazepine (CBZ) and divalproex sodium (VPA) developed frequent upward gaze episodes.
- The upward gaze episodes correlated with increased VPA dosage initially.
- Subsequent recurrence and resolution were linked to carbamazepine (CBZ) dosage adjustments.
Findings:
- The oculogyric crisis (OGC) was strongly suspected to be induced by carbamazepine (CBZ).
- Dosage reduction of CBZ led to the prompt resolution of OGC symptoms.
- This case highlights a potential drug-induced movement disorder.
Implications:
- Clinicians should consider carbamazepine (CBZ) as a potential cause of oculogyric crises (OGC).
- Careful monitoring and dose adjustment of CBZ may be necessary in patients experiencing such adverse events.
- This finding contributes to understanding the neurotoxic effects of antiepileptic drugs.