Pogoršanje simptomatske okcipitalne dečje epilepsije izazvano karbamazepinom
Sažetak
Uvod. Karbamazepin može dovesti do pogoršanja epileptičnih napada kod generalizovanih epilepsija (primarnih ili sekundarnih), koje u kliničkoj slici imaju apsanse (tipične ili atipične) i/ili mioklonusne napade. I neke fokalne epilepsije, međutim, mogu se pogoršati uvođenjem karbamazepina. Prikaz bolesnika. Prikazali smo dečaka, starog 10 godina, rođenog posle komplikovanog i produženog porođaja koji je završen vakuum ekstrakcijom, urednog ranog psihomotornog razvoja. U 8 godini imao je prvi epileptični napad, tipa jednostavnog okcipitalnog, sa generalizacijom i umokravanjem. Nalaz snimanja magnetnom rezonancom (MRI) mozga ukazao je na fokalne kortikalne reduktivne promene parietookcipitalno, levo. Interiktusni EEG je beležio usporenu osnovnu aktivnost iznad zadnjih regiona leve hemisfere, sa povremenim izbijanjem okcipitalnih oštrih talasa, i biokcipitalnih oštar talas-spori talas kompleksa. U početku dečak je lečen valproatom, a kada je u terapiju uveden i karbamazepin, došlo je do pogoršanja napada, EEG nalaza, promene ponašanja i lošeg uspeha u školi. Isključenjem karbamazepina stanje se popravilo, kako klinički, tako i u EEG nalazu. Zaključak. Lezione okcipitalne epilepsije u detinjstvu pokazuju pogoršanje sa karbamazepinom, jer posle njegovog uvođenja dolazi do pogoršanja napada, promena ponašanja, kognicije sa pojavom dugotrajnih bilateralnih pražnjenja i posteriornih oštar talas-spori talas kompleksa visoke amplitude u EEG.
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