Epileptik Bir Çocukta Amanita Virosa Alımı Sonrası Refrakter Status Epileptikus Oluşması

Yıl 2014, Cilt: 5 Sayı: 4, 110 - 112, 01.04.2014

Çapan Konca , Ali Güneş Halil Kocamaz Servet Yel Mehmet Boşnak

Öz

Giriş: Status epileptikus nöbetinin benzodiyazepin
uygulanmasından sonra bir geleneksel entiepileptik ilaç
infüzyonuna rağmen devam etmesi ise refrakter status epileptikus
olarak tanımlanmaktadır. Mantar zehirlenmeleri değişik klinik
tablolara neden olabilmektedir. Mantar zehirlenmelerine bağlı
epileptik nöbet geliştiği bilinmekle birlikte literatürde amanita
virosa grubu mantar zehirlenmesine bağlı status epileptikus
geliştiğine dair bir bilgi bulunmamaktadır.
Olgu Sunumu: Altı yaşında, son iki yıldır nöbet öyküsü olmayan
ve ilaçlarını düzenli kullanan epileptik erkek hasta, mantar alımı
sonrası refrakter status epileptikus tablosunda acil servise getirildi.
Antiepileptik tedavi ile kontrol altına alınamayan nöbet aktivitesi
genel anestezi eşliğinde entübasyon ve mekanik ventilasyon
uygulaması ile kontrol altına alındı. Laboratuar incelemeleri,
PTZ ve aPTT yüksekliği dışında normaldi. Takibinde ek problem
olmayan ve stabil hale gelen hasta yatışının beşinci günde şifa ile
taburcu edildi.
Sonuç: Hastada mantar zehirlenmesinin konvülziyon eşiğini
düşürücü etkisinin olabileceği düşünüldü. Bu olgu ile
zehirlenmelerde kliniğin her zaman klasik literatür bilgilerine
uymayabileceği, bazen de farklı kliniklerin bir hastada aynı anda
görülebileceğinin düşünülmesi gerektiği vurgulandı.

Anahtar Kelimeler

Amanita virosa, çocuk, mantar zehirlenmesi, refrakter, status epileptikus

Refractory Status Epilepticus After Ingestion of Amanita Virosa in an Epileptic Child

Öz

Introduction: Status epilepticus is considered refractory when seizure activity continues after receiving treatment with a benzodiazepine followed by infusion of traditional antiepileptic drugs. Mushroom poisoning may lead to variable clinical pictures. Although it is known that mushroom poisoning may develop epileptic seizures, there are no data about status epilepticus associated with amanita virosa mushroom poisoning in the literature. Case Report: A 6-year-old epileptic patient who regularly used antiepileptic drugs and had no seizures for 2 years was admitted to the emergency department due to refractory status epilepticus after ingestion of mushroom. Seizures that were refractory to antiepileptic therapy was controlled with intubation and mechanical ventilation after general anesthesia. Laboratory tests were normal, except elevated PTZ and aPTT. The patient, who had no additional problems and stabilized, was discharged on the fifth day of admission. Conclusion: We suggested that mushroom poisoning may reduce the threshold for seizures in our patient. In this study, it is emphasized that different clinical features may be found in a patient at the same time

Anahtar Kelimeler

Amanita virosa, child, mushroom poisoning, refractory, status epilepticus

Kaynakça

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