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Lamotrigine childhood overdose
G Briassoulis1, P Kalabalikis, M Tamiolaki
1Pediatric Intensive Care Unit, Aghia Sophia Children's Hospital, Athens, Greece.
Pediatric Neurology
|November 7, 1998
Summary
A child experienced a lamotrigine overdose, presenting with neurological symptoms like seizures and tremors. This case highlights the importance of monitoring for adverse effects in pediatric lamotrigine overdose, even when other systems appear unaffected.
Area of Science:
- Pediatric Neurology
- Clinical Toxicology
Background:
- Lamotrigine is an anticonvulsant medication used to treat epilepsy and bipolar disorder.
- Overdose cases in children are rare, and the concentration-effect relationship is not well-established.
Observation:
- A 2-year-old male ingested a significant overdose of lamotrigine (800 mg).
- The child presented with generalized tonic-clonic seizures, limb tremors, muscle weakness, ataxia, and hypertonia.
- Vital signs, EEG, and routine labs were normal; urine toxicology was negative for other substances.
Findings:
- Plasma lamotrigine levels were high (3.8 mg/L), within the adult therapeutic range, with a slow elimination rate.
- The patient's neurological symptoms resolved within 24 hours after treatment with midazolam, gastric lavage, activated charcoal, and fluids.
- This is the first reported case of seizure activity associated with lamotrigine overdose in a child, exclusively manifesting with neurological abnormalities.
Implications:
- This case underscores the potential for severe neurological adverse effects in pediatric lamotrigine overdose.
- Further research is needed to establish a clear concentration-effect-side-effect relationship for lamotrigine in children.
- Clinicians should be vigilant for neurological symptoms in pediatric patients with suspected lamotrigine overdose.