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

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.
Authors	Giangaetano D'Aleo, Carmela Rifici, Markus Kofler, Edoardo Sessa, Leopold Saltuari, Placido Bramanti
Journal	Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology (Neurol Sci) Vol. 32 Issue 2 Pg. 293-5 (Apr 2011) ISSN: 1590-3478 [Electronic] Italy
PMID	20607336 (Publication Type: Case Reports, Journal Article)
Chemical References	Anticonvulsants Antipsychotic Agents GABA-B Receptor Agonists Benzodiazepines Carbamazepine Baclofen Olanzapine Oxcarbazepine
Topics	Adult Anticonvulsants (therapeutic use) Antipsychotic Agents (therapeutic use) Baclofen (administration & dosage, adverse effects, therapeutic use) Benzodiazepines (therapeutic use) Carbamazepine (analogs & derivatives, therapeutic use) Female GABA-B Receptor Agonists (administration & dosage, adverse effects, therapeutic use) Humans Injections, Spinal Multiple Sclerosis, Chronic Progressive (drug therapy) Olanzapine Oxcarbazepine Seizures (chemically induced)

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