Reactions 1199 - 26 Apr 2008

STheophylline

Seizures and benign tumour: 8 case reportsEight patients experienced first-episode seizures, while

receiving theophylline for asthma [dosages and durations oftherapy to reaction onset not stated]. One patient alsodeveloped a cerebral venous angioma.

An 18-month-old infant boy with a family history ofidiopathic generalised epilepsy was hospitalised withgeneralised seizures and a fever of ≥ 38°C. An EEG showed leftslow waves, and on a brain CT there was left temporalhypoperfusion. An MRI was unremarkable. Theophylline wasdiscontinued and he experienced no further seizures.

A 20-month-old infant boy with a strong family history ofseizures was hospitalised with right unilateral seizures and afever of ≥ 38°C. An EEG showed left low amplitude waves, andon an MRI there were left temporal high amplitude waves. Healso displayed hemiconvulsion, hemiplegia and epilepsy. Hisserum theophylline concentration was 1.5 µg/mL.Theophylline was discontinued and he experienced no furtherseizures.

A girl of 2 years and 3 months, with a family history ofseizures, was hospitalised with generalised seizures and afever of ≥ 38°C. An EEG showed diffuse slow waves, and on abrain CT there was left temporal hypoperfusion. An MRI wasunremarkable. Her serum theophylline concentration was4.7 µg/mL. Theophylline was discontinued and sheexperienced no further seizures.

A boy of 2 years and 7 months, with a family history ofseizures, was hospitalised with general tonic-clonic seizuresand a fever of ≥ 38°C. An EEG showed diffuse slow waves, andan MRI was unremarkable. Theophylline was discontinued andhe experienced no further seizures.

A 4-year-old boy with a family history of idiopathicgeneralised epilepsy was hospitalised with complex partialseizures with secondary generalisation, and a fever of ≥ 38°C.An EEG showed temporal spikes, but an MRI wasunremarkable. His serum theophylline concentration was14 µg/mL. Theophylline was discontinued and he experiencedno further seizures.

A 4-and-a-half-year-old girl was hospitalised with complexpartial seizures with secondary generalisation, and a fever of≥ 38°C. An EEG showed right slow waves, and on a brain CTthere was right frontal hypoperfusion. An MRI wasunremarkable. Her serum theophylline concentration was21.7 µg/mL. Theophylline was discontinued and sheexperienced no further seizures.

A boy of 4 years and 8 months was hospitalised with generaltonic-clonic seizures and a fever of ≥ 38°C. An EEG showed leftslow waves. His serum theophylline concentration was6 µg/mL. Theophylline was discontinued and he experiencedno further seizures.

A 6-year-old girl had a strong family history of seizures.During theophylline treatment, she would experience aperiodic, intractable headache with fever (temperature≥ 38°C), which would sometimes progress to a clonic seizure(left-side dominant). An interictal EEG showed right frontal-temporal-parietal spikes. An MRI and angiography revealed aright deep lateral cerebral venous angioma. Her serumtheophylline concentration was 13.6 µg/mL. Theophylline wasdiscontinued. Both the seizures and the subclinical EEG spikesceased.

Author comment: "[A]ll patients had no recurrence of anyconvulsions after the cessation of theophylline administration.These results suggest that the administration of theophyllinewas the trigger for their convulsions."Korematsu S, et al. Theophylline-associated seizures and their clinicalcharacterizations. Pediatrics International 50: 95-98, No. 1, Feb 2008 -Japan 801104000

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Reactions 26 Apr 2008 No. 11990114-9954/10/1199-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved