Reactions Weekly | 2021
Levetiracetam/oxcarbazepine/phenobarbital
Abstract
Lack of efficacy: case report A female infant [age at the reaction onset not stated] exhibited lack of efficacy during treatment with levetiracetam, oxcarbazepine and phenobarbital for myoclonic seizures. The infant was born at full-term to a healthy nonconsanguineous couple. She had early myoclonic encephalopathy (EME) secondary to heterozygous variants of the RARS2 gene. On day of life 2 (DOL 2), she presented with groan. At DOL 19, she presented with partial or fragmentary erratic myoclonus and muscular hypertonia. Relevant investigations were unremarkable. For the management of myoclonic seizures, she received antiepileptic therapy with phenobarbital 5 mg/kg/d (started at DOL 21), levetiracetam 30 mg/kg/d, (started at DOL 29) and oxcarbazepine 20 mg/kg/d (started at DOL 38) [routes not stated]. However, this treatment was not effective, and was therefore discontinued at the age of 5 months. Soon after, she developed convulsive status epilepticus. Later, at the age of 7 months, she developed infantile spasms and had severe developmental delay.