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頁籤選單縮合
題名 | Vigabatrin Induced Psychosis: Report of a Case=Vigabatrin引起的精神病:一例報告 |
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作者 | 劉興政; 李宇宙; 曾美智; 李明濱; Liu, Hsing-cheng; Lee, Yue-joe; Tseng, Mei-chih; Lee, Ming-been; |
期刊 | 臺灣精神醫學 |
出版日期 | 19970900 |
卷期 | 11:3 1997.09[民86.09] |
頁次 | 頁82-87 |
分類號 | 418.21 |
語文 | eng |
關鍵詞 | 癲癇症; Vigabatrin; GABA; GABA-aminotransferase; Epilepsy; |
中文摘要 | 目的︰癲癇病患可能會出現許多種精神病理的變化,其中又以產生類似精神分裂病的精神症狀引起最多的討論。對於癲癇病患的精神症狀的討論,經常是討論到癲癇型態、病史、腦波變化以及大腦結構病理變化等因素與精神症狀的關係。對於癲癇發作頻率與精神症狀之間也有許多爭論,有的學者認為兩者是相互拮抗,但有人並不支持這種說法。而極少討論有關抗癲癇藥物引起的精神症狀,尤其是傳統的抗癲癇藥物。Vigabatrin是一種新的抗癲癇藥物,作用機轉為GABA的代謝酵素GABA-aminotransferase的抑制劑,可以增加腦中GABA的含量,而有抗癲癇的效果。病例報告︰本文報告一位女性癲癇病人,在使用vigabatrin之後,癲癇症狀明顯改善,但此時卻出現幻聽等精神症狀,且精神症狀在停用vigabatrin之後消失。結論︰作者認為這是一個因抗癲癇藥物使腦內GABA上升,而引起的精神症狀的個案;本案例提示,癲癇病患合併精神症狀時,抗癲癇藥物可能是原因之一。文中對於癲癇症、精神症狀和GABA之間的關係亦加以探討。 |
英文摘要 | Objective: Variors psychopathological manifestations are commonly seen in epileptic patients. Schizophrenia-like psychosis has received much consideration. Previous findings mostly focused on the relationship between psychosis and epilepsy per se. Some authors believe that psychosis and epilepsy are antagonistic to each other. Conventional anticonvulsants receive little consideration as a cause of psychosis. Vigabatrin, an irreversible inhibitor of gamma-aminobutyric acid aminotransferase (GABA-aminotrans-ferase), is a new anticonvulsant and it is effective in refractory epilepsy. Vigabatrin can increase the GABA level in the brain and this is believed to be its anticonvulsant effect. Case Report: We report on a female with symptomatic epilepsy who developed brief psychosis while receiving vigabatrin treatment. The psychotic symptoms were present in clear consciousness and disappeared after discontinuing the drug. Conclusion: Increased GABA by vigabatrin may be the cause of psychotic symptoms in our case. This reminds us that anticonvulsant may be a cause of psychois in chronic epileptic patients. |
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