Tiagabine-induced nonconvulsive status epilepticus in an adolescent without epilepsy

Abstract

Tiagabine (TGB) is a γ-aminobutyric acid (GABA) reuptake inhibitor approved as adjunctive therapy for partial seizures in patients over age 12. It has been used off-label to treat depression, anxiety, bipolar disorder, neuropathic pain, headache, and spasticity. A recent epidemiologic study found that TGB adjunctive therapy does not increase the risk of status epilepticus (SE).1 However, there are now more than a dozen reports of precipitation of nonconvulsive status epilepticus (NCSE) in patients predisposed to seizures, including children,2 or in patients without epilepsy treated chronically with TGB.3 In February 2005, Cephalon, the manufacturer of TGB, issued a warning of the possibility of seizures in patients without epilepsy. We report a case of NCSE after TGB overdose in a 14-year-old girl who neither had epilepsy nor was taking the medication chronically. The present description clarifies some inaccuracies in an earlier report by others of our clinical and EEG findings in this case.4 The patient was a 14-year-old right-handed girl in good health except for mild asthma. On the day of admission, she was found at home obtunded after having ingested an estimated …