ID 343 – Oral carbamazepine controlled temporal complex partial status epilepticus

Objective Temporal complex partial status epilepticus TCPSE is a condition usually manifest as variable periods of confusion with a prolonged epileptic episode. In our case report on two patients with TCPSE we study the response to carbamazepine after failure of first and second line therapy. Methods Clinical case report. Results Case 1: A 39-year old women with cryptogenic epilepsy, was treated with phenobarbital PB 100 mg/day. Prolonged disturbed consciousness over 3 days, after abrupt withdrawal of PB. Experiencing visual and auditory hallucinations. EEG showed continuous left temporal spike/wave and slow waves discharges. Normal brain MRI. No response to intravenous Diazepam 0.15 mg/kg and PB 15 mg/kg after four days. Clinical improvement and ictal EEG pattern resolved after oral Carbamazepine CBZ treatment 600 mg/day. Case 2: A 61-year old women with symptomatic complex partial seizure disorder, secondary to CNS lymphoma. Was treated with PB 100 mg/day and CBZ600 mg/day. Confusion with agitation and experiencing visual hallucinations, after abrupt withdrawal of CBZ. EEG revealed continuous temporal slow waves. CT scanning was unchanged from imaging studies six month earlier. No response to intravenous Diazepam 0.1 mg/kg and PB 15 mg/day after three days. Improvement in her clinical delirium and EEG pattern after oral CBZ treatment 600 mg/day. Conclusion CBZ was effective and safe in controlling TCPSE in our patients. Oral administration of CBZ is an effective alternative.