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A Case of Downbeat Nystagmus Induced by Carbamazepine Intoxication
著者
松田, 和徳 徳島県立中央病院|徳島大学 KAKEN研究者をさがす
福田, 潤弥 徳島大学
高岡, 奨 徳島大学
戸村, 美紀 徳島県立中央病院|徳島大学
松岡, 百百世 徳島大学
今井, 貴夫 大阪大学
キーワード
carbamazepine
downbeat nystagmus
carbamazepine intoxication
資料タイプ
学術雑誌論文
抄録
We report the case of a 33-year-old man who presented with disequilibrium and downbeat nystagmus. Balance testing showed failure of visual suppression of caloric nystagmus with insufficient optokinetic nystagmus responses, suggesting central vestibular dysfunction. However, MRI showed no lesions in the brain, including in the cerebellum. The patient had been diagnosed previously as having epilepsy, and the convulsions had remained under control for more than 10 years with a maintenance dose of carbamazepine (900mg/day). Blood tests revealed a serum level of carbamazepine of 10.7mEq/l, which was over the therapeutic range (4.0-10.0mEq/l). Therefore, his carbamazepine dose was reduced, and with a reduction of the dose to 600mg/day, his disequilibrium and downbeat nystagmus gradually disappeared, along with a decrease in return of the serum level of carbamazepine to the therapeutic range. Therefore, we diagnosed the disequilibrium with downbeat nystagmus in this patient as having been caused by carbamazepine intoxication. Although carbamazepine is metabolized by CYP3A4 in the liver, elevated levels of the drug have been reported in cases of renal failure. As he also suffered from polycystic kidneys, we consider that the progressive renal dysfunction in our patient could have precipitated the carbamazepine intoxication.
掲載誌名
Equilibrium Research
ISSN
1882577X
03855716
cat書誌ID
AN00001485
出版者
日本めまい平衡医学会
82
1
開始ページ
26
終了ページ
33
発行日
2023-02-28
EDB ID
出版社版DOI
出版社版URL
フルテキストファイル
言語
jpn
著者版フラグ
出版社版
部局
病院
医学系