Seizure after intrathecal baclofen bolus in a multiple sclerosis patient treated with oxcarbazepine

Neurol Sci. 2011 Apr;32(2):293-5. doi: 10.1007/s10072-010-0364-8. Epub 2010 Jul 6.

Abstract

Epileptic seizures associated with intrathecal baclofen (ITB) application have been observed in patients with traumatic brain injury. A higher incidence of seizures has also been reported in patients with multiple sclerosis (MS) receiving ITB. To our knowledge, no case of a first epileptic seizure has been reported in the context of ITB bolus testing in MS. We report a 41-year-old female patient with primary progressive MS receiving olanzapine and oxcarbazepine for psychotic disorder. Five years prior she began to develop severe spastic quadriparesis, rendering her a candidate for ITB treatment. After ITB test bolus application, however, she experienced a first epileptic seizure. Our observation indicates that ITB may trigger seizures in patients with MS. The observed seizure occurred during ITB bolus testing despite antiepileptic co-medication, which concurs with previous reports suggesting that rapid changes in the dose of ITB may carry a higher risk of seizure induction.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anticonvulsants / therapeutic use
  • Antipsychotic Agents / therapeutic use
  • Baclofen / administration & dosage
  • Baclofen / adverse effects*
  • Baclofen / therapeutic use
  • Benzodiazepines / therapeutic use
  • Carbamazepine / analogs & derivatives
  • Carbamazepine / therapeutic use
  • Female
  • GABA-B Receptor Agonists / administration & dosage
  • GABA-B Receptor Agonists / adverse effects*
  • GABA-B Receptor Agonists / therapeutic use
  • Humans
  • Injections, Spinal
  • Multiple Sclerosis, Chronic Progressive / drug therapy*
  • Olanzapine
  • Oxcarbazepine
  • Seizures / chemically induced*

Substances

  • Anticonvulsants
  • Antipsychotic Agents
  • GABA-B Receptor Agonists
  • Benzodiazepines
  • Carbamazepine
  • Baclofen
  • Olanzapine
  • Oxcarbazepine