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Tiagabine-related status epilepticus: a case report and systematic literature review

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Abstract

Tiagabine-related status epilepticus (SE) is an uncommon complication of tiagabine use. We aimed to detail the features and outcomes in a patient with tiagabine poisoning and review the relevant literature. We describe a case of tiagabine-related SE and literature review based on a 1995–2019 PubMed search. We report the case of a 30-year-old man with super-refractory SE after tiagabine poisoning. He fully recovered after 72 h of general anesthesia and was discharged from the ICU on day 16. A literature review showed distinct features among patients with tiagabine-related SE. Tiagabine side effects were characterized by non-convulsive SE after a slight increase in tiagabine dose and a rapid favorable evolution after benzodiazepine and early tiagabine withdrawal. Generalized convulsive SE was a complication of voluntary or involuntary tiagabine poisoning and was particularly refractory. Both presentations are characterized by a return to baseline after prompt and adequate management. Tiagabine-related SE electroclinical features vary according to the underlying pathophysiological mechanism and can be life threatening. Recovery is the rule after tiagabine withdrawal and SE management with progressive therapeutic escalation guided by response to prior anticonvulsant treatments.

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Notes

  1. https://www.R-project.org. Accessed September 16, 2019.

Abbreviations

SE:

Status epilepticus

ICU:

Intensive care unit

GABA:

Gamma-aminobutyric acid

GAT-1:

GABA transporter 1

IQR:

Interquartile range

EEG:

Electroencephalogram

NCSE:

Non-convulsive status epilepticus

CSE:

Convulsive status epilepticus

5-HT2:

5-Hydroxytryptamine 2

GCSE:

Generalized convulsive status epilepticus

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Acknowledgement

We thank the Centre Hospitalier de Versailles for editorial assistance.

Funding

We received no funds for this study.

Author information

Authors and Affiliations

  1. Intensive Care Unit, Centre Hospitalier de Versailles–Site André Mignot, 78150, Le Chesnay, France

    Geoffroy Hariri, Alexis Ferre & Stephane Legriel

  2. Assistance Publique–Hôpitaux de Paris (AP-HP), Hôpital Saint-Antoine, Service de Réanimation Médicale, 184 rue du Faubourg Saint-Antoine, 75571, Paris Cedex 12, France

    Geoffroy Hariri

  3. IctalGroup, Le Chesnay, France

    Stephane Legriel

  4. University Paris-Saclay, UVSQ, INSERM, CESP, Team « PsyDev », Villejuif, France

    Stephane Legriel

  5. Medical Intensive Care Unit, Centre Hospitalier Universitaire Saint-Antoine, Assistance Publique Hôpitaux de Paris, 184 Rue du Faubourg Saint-Antoine, 75012, Paris, France

    Geoffroy Hariri

Authors
  1. Geoffroy Hariri
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Contributions

GH: conceived and designed the trial, collected data, analyzed and interpreted the data, wrote the first draft of the manuscript, and approved the final version of the manuscript. AF: collected data and approved the final version of the manuscript. SL: conceived, designed, and supervised the trial, coordinated data collection, analyzed and interpreted the data, wrote the first draft and final version of the manuscript.

Corresponding author

Correspondence to Geoffroy Hariri.

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Conflict of interest

The authors have declared that there are no competing interests. Geoffroy Hariri: reports no financial relationships relevant to the study. Alexis Ferre: reports no financial relationships relevant to the study. Stephane Legriel: reports no financial relationships relevant to the study.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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For the case we report, informed consent was given by the family of the patient.

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Hariri, G., Ferre, A. & Legriel, S. Tiagabine-related status epilepticus: a case report and systematic literature review. Acta Neurol Belg 120, 1283–1288 (2020). https://doi.org/10.1007/s13760-020-01464-6

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  • DOI: https://doi.org/10.1007/s13760-020-01464-6

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