氟喹诺酮类药物引致癫痫发作54例的国内文献回顾

Seizures induced by fluoroquinolones in 54 cases:a review of domestic literature

目的:了解氟喹诺酮类药物引致癫痫发作的发生情况及临床特点。方法:收集与分析中国生物医学文献数据库(1978-01-2006-06)及中国医院数字图书馆期刊全文库(1994-01-2006-06)中氟喹诺酮类药物所致癫痫发作病例。结果:氟喹诺酮类药物所致癫痫发作54例,男性31例,女性23例,其中5例有癫痫史。引起癫痫发作的常见药物依次为环丙沙星、氧氟沙星、左氧氟沙星、诺氟沙星等。静脉给药43例,口服7例,4例不明。6例合用茶碱制剂。54例中,47例为全面性强直阵挛发作,7例为部分发作,发作的开始时间在用药后10min至6d。发作持续时间为20s至10min,发作次数为1～5次。54例中除1例死于脑胶质瘤、脑梗死外,其余患者均在停药或对症治疗后好转出院。结论:静脉或口服应用氟喹诺酮类药物均可引致癫痫发作。临床医生应了解氟喹诺酮类药物所致癫痫发作的危害以利于安全用药。

Objective： To understand the occurrence and clinical features of seizures induced by fluoroquinolones. Methods： The reported cases with seizures induced by fluoroquinolones from CBMdisc （1978-01-2006-06） and CHDL（1994-01-2006-06） were collected and analyzed. Results： Fifty-four patients with fluoroquinolones-induced seizures （31 males, 23 females） were collected. Five of them had a previous history of epilepsy, The common causative medications, in the order offi＇equency, were ciprofloxacin, ofloxacin, levofloxacin, norfloxacin, and so on. Forty three patients were administered intravenously, and 7 patients were administered orally. Six patients were coadministered with theophylline-containing preparations. Of the 54 patients, 47 were generalized tonic-clonic seizures, 7 were partial seizures. The time of onset of seizures was 10 min to 6 d after fluoroquinolones use. The duration of seizures was 20 s to 10 min. The seizure frequency was 1 to 5 times. After drug withdrawal or systematic therapy, all the patients had recovered and were discharged, except one patient died from neurospongioma and cerebral infarction. Conclusion： Seizures might be induced by intravenous or oral administration of fluoroquinolones. Clinicans should be aware of the risks of fluoro quinolones-induced seizures in order to be beneficial to safe drug use.