Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose
Background. 4-Aminopyridine (4-AP) is a drug that is used to improve motor fatigue in patients suffering from multiple sclerosis (MS). Medication error can occur, as commercial preparation may not be available in some countries. Case Presentation. A 58-year-old woman with progressive MS presented wi...
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| Format: | Article |
| Language: | English |
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Wiley
2014-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2014/237064 |
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| author | Maria Ballesta Méndez Vincent van Pesch Arnaud Capron Philippe Hantson |
| author_facet | Maria Ballesta Méndez Vincent van Pesch Arnaud Capron Philippe Hantson |
| author_sort | Maria Ballesta Méndez |
| collection | DOAJ |
| description | Background. 4-Aminopyridine (4-AP) is a drug that is used to improve motor fatigue in patients suffering from multiple sclerosis (MS). Medication error can occur, as commercial preparation may not be available in some countries. Case Presentation. A 58-year-old woman with progressive MS presented with status epilepticus. She was receiving 4-AP for more than 3 years. The symptoms started soon after the ingestion of a single pill that was supposed to contain 10 mg 4-AP, but further investigations revealed that each pill had been inadvertently prepared with an 100 mg 4-AP concentration. The patient was admitted to the intensive care unit (ICU) for appropriate management (orotracheal intubation, sedation, and antiepileptic drugs). The first electroencephalogram (EEG) showed abundant irregular spike-waves on the left central regions. Neurological condition gradually improved from day 7, while the EEG did not reveal any more electrical seizures but was still consistent with toxic encephalopathy. The patient stayed in the ICU until day 13. At discharge from the rehabilitation ward (2.5 months later), the patient had not yet recovered her previous cognitive and functional condition. Conclusion. A single 100 mg 4-AP accidental overdose may cause serious immediate complications, with a slow and incomplete neurological recovery. |
| format | Article |
| id | doaj-art-0e9e05d50b124fe09ca9037e95de8af5 |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2014-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-0e9e05d50b124fe09ca9037e95de8af52025-02-03T01:02:28ZengWileyCase Reports in Neurological Medicine2090-66682090-66762014-01-01201410.1155/2014/237064237064Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine OverdoseMaria Ballesta Méndez0Vincent van Pesch1Arnaud Capron2Philippe Hantson3Department of Intensive Care, Cliniques St-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, BelgiumDepartment of Neurology, Cliniques St-Luc, Université Catholique de Louvain, 1200 Brussels, BelgiumLouvain Centre for Toxicology and Applied Pharmacology, Université Catholique de Louvain, 1200 Brussels, BelgiumDepartment of Intensive Care, Cliniques St-Luc, Université Catholique de Louvain, Avenue Hippocrate 10, 1200 Brussels, BelgiumBackground. 4-Aminopyridine (4-AP) is a drug that is used to improve motor fatigue in patients suffering from multiple sclerosis (MS). Medication error can occur, as commercial preparation may not be available in some countries. Case Presentation. A 58-year-old woman with progressive MS presented with status epilepticus. She was receiving 4-AP for more than 3 years. The symptoms started soon after the ingestion of a single pill that was supposed to contain 10 mg 4-AP, but further investigations revealed that each pill had been inadvertently prepared with an 100 mg 4-AP concentration. The patient was admitted to the intensive care unit (ICU) for appropriate management (orotracheal intubation, sedation, and antiepileptic drugs). The first electroencephalogram (EEG) showed abundant irregular spike-waves on the left central regions. Neurological condition gradually improved from day 7, while the EEG did not reveal any more electrical seizures but was still consistent with toxic encephalopathy. The patient stayed in the ICU until day 13. At discharge from the rehabilitation ward (2.5 months later), the patient had not yet recovered her previous cognitive and functional condition. Conclusion. A single 100 mg 4-AP accidental overdose may cause serious immediate complications, with a slow and incomplete neurological recovery.http://dx.doi.org/10.1155/2014/237064 |
| spellingShingle | Maria Ballesta Méndez Vincent van Pesch Arnaud Capron Philippe Hantson Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose Case Reports in Neurological Medicine |
| title | Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose |
| title_full | Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose |
| title_fullStr | Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose |
| title_full_unstemmed | Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose |
| title_short | Prolonged Toxic Encephalopathy following Accidental 4-Aminopyridine Overdose |
| title_sort | prolonged toxic encephalopathy following accidental 4 aminopyridine overdose |
| url | http://dx.doi.org/10.1155/2014/237064 |
| work_keys_str_mv | AT mariaballestamendez prolongedtoxicencephalopathyfollowingaccidental4aminopyridineoverdose AT vincentvanpesch prolongedtoxicencephalopathyfollowingaccidental4aminopyridineoverdose AT arnaudcapron prolongedtoxicencephalopathyfollowingaccidental4aminopyridineoverdose AT philippehantson prolongedtoxicencephalopathyfollowingaccidental4aminopyridineoverdose |