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Eye rolling as a manifestation of clobazam toxicity in a child with epilepsy
Author(s) -
Aylett Sarah E,
Cross Helen,
Berry Dave
Publication year - 2006
Publication title -
developmental medicine and child neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.658
H-Index - 143
eISSN - 1469-8749
pISSN - 0012-1622
DOI - 10.1111/j.1469-8749.2006.tb01325.x
Subject(s) - clobazam , epilepsy , ataxia , lamotrigine , medicine , toxicity , anesthesia , generalized epilepsy , anticonvulsant , pediatrics , psychiatry
A four‐year‐old male with symptomatic generalized epilepsy presented with ataxia, eye rolling, and episodes of back arching which were of non‐epileptic origin following the introduction of clobazam at 0.75mg/kg/day. Concurrent antiepileptic medication was lamotrigine at 13mg/kg/day. Clobazam plasma levels were within the normal range, while N‐desmethylclobazam (DCLB) concentrations were between five and seven times above the upper limit of the normal range. The plasma elimination half‐life for DCLB was prolonged, suggesting a genetic variability in DCLB metabolism leading to toxicity. Reduction in the dose of clobazam to 0.3mg/kg/day was associated with resolution of the non‐epileptic neurological symptoms, reduction in DCLB plasma levels, and maintenance of seizure control.