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Children with Seizure Disorders After Administration of an Anti‐allergic Medicine
Author(s) -
Yasuhara Akihiro,
Ochi Ayako,
Araki Atsushi,
Kitamura Naoyuki,
Harada Yoshiaki
Publication year - 1998
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1998.tb01931.x
Subject(s) - ketotifen , medicine , hypsarrhythmia , histaminergic , atopic dermatitis , anesthesia , antihistamine , epilepsy , asthma , histamine , dermatology , psychiatry
Purpose : Histamine is a neurotransmitter in the mammalian brain, and the central histaminergic system is known to have an inhibitory effect on epileptic seizures. We found 19 children with seizure disorders and EEG abnormalities after the administration of an antiallergic medicine (Ketotifen). Ketotifen has been used for its antihistaminergic action for the treatment of severe allergic disorders such as atopic dermatitis and bronchial asthma. Methods and Results : We classified the 19 patients into five groups as follows. Group A had two patients who had a previous history of seizures controlled by antiepileptic drugs (AEDs). They had convulsive disorders and EEG spikes after the administration of Ketotifen. After the cessation of Ketotifen, the seizures disappeared. Group B had two patients with a history of febrile convulsions. After the administration of Ketotifen for atopic dermatitis, they had nonfebrile convulsions. The seizures disappeared after discontinuance of Ketotifen. Group C had five patients who had nonepileptic symptoms, including premature birth or renal failure, and who showed spike discharges on the EEG after the administration of Ketotifen. The spike discharges disappeared after the discontinuance of Ketotifen. Group D had eight patients who had been treated with Ketotifen for atopic dermatitis or bronchial asthma, and who had febrile convulsions. The ages ranged between 10 months and 5 years. The prolonged convulsions lasted between 10 and 120 min, with a mean of 40 min. An abnormal EEG was recorded in seven of the eight patients. Group E had two patients with infantile spasms and hypsarrhythmia 8–10 days after the administration of Ketotifen at age 3 months. They were diagnosed as having West syndrome because of the tonic spasms, hypsarrhythmia, and developmental arrest. Conclusions : Histamine has an anticonvulsive effect through the histamine H 1 receptor in the brain. Ketotifen has been used as an anti‐allergic medicine and is known to be a histamine H 1 antagonist. The central histaminergic system plays an important role in inhibiting convulsions in infants, before the γ‐aminobutyric acid (GABA) system fully develops its inhibitory function. We analyzed the 19 patients with seizure disorders after Ketotifen administration and found that young children who were susceptible to seizures were triggered for seizures by this H 1 antagonist. It is still unknown whether the administration of Ketotifen itself produces or triggers seizures during infancy.