Ｚｏｎｉｓａｍｉｄｅの再投与により舞踏病アテトーゼ様不随意運動をきたした難治性てんかんの１例

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  • A Case of Intractable Epilepsy Which Showed Choreoathetotic Involuntary Movements by Re-administration of Zonisamide.

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This is a case of mentally retarded 26 year-old woman who has an intractable epilepsy with the onset in childhood. The epilepsy was classified as an undetermined epilepsy. From the age of 20 years, she was administered zonisamide increasing up to 400mg per day for about two years in addition to valproic acid and clonazepam. The serum concentration of zonisamide was 36.7μg/ml, but the seizures were not controlled sufficiently. Moreover, because the patient complained of sleepiness and loss of appetite after she was administered full dose of zonisamide, the patient was stopped to be administered zonisamide only by the decision of her mother.<BR>At the age of 26 years, she was administered acetazolamide with the gradual increase of the dose combined with phenobarbital and phenytoin. She was admitted to the hospital because she showed frequent seizures with no specific reasons. On the first day of admission, acetazolamide was stopped and zonisamide was introduced again with the intial daily dose of 160mg. The seizures were not controlled with the intravenous administration of diazepam and phenytoin, but the seizures disappeared almost completely with the intravenous administration of lidocaine. After a week of readministration of zonisamide, generalized choreoathetotic involuntary movements were recognized continuously during the wakening stage. At this moment, the serum concentrations of phenobarbital, phenytoin and zonisamide were 28.5μg/ml, 8.9μg/ml and 5.2μg/ml, respectively. The choreoathetotic movements were considered as a side effect of zonisamide and the movements disappeared four days after discontinuing the medical agent.

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  • てんかん研究

    てんかん研究 17 (2), 128-134, 1999

    一般社団法人 日本てんかん学会

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