卡马西平致阿-斯综合征

Adams-Stokes syndrome induced by carbamazepine

1例74岁女性患者因急性缺血性脑卒中后癫痫发作给予卡马西平0．1g口服，3次／d。第3天，患者突然出现嗜睡并于30min内进展为浅昏迷，心电图检查示心率34次/min，交界性心律，提示病态窦房结综合征。考虑可能为卡马西平所致阿一斯综合征。立即给予硫酸阿托品0．5mg静脉注射，随后以硫酸阿托品1mg＋5％葡萄糖注射液500ml缓慢静脉滴注。2h后患者苏醒，复查心电图示恢复窦性心律，心率48次／min。停用卡马西平，患者未再出现意识障碍。

A 74-year-old female patient received oral carbamazepine 0. lg thrice daily because of epilepsy after acute ischemic stroke. On the third day, the patient suddenly presented drowsiness which gradually aggravated to a state of mild coma within 30 minutes. The electrocardiogram showed that sick sinus syndrome and junctional rhythm with a heart rate of 34 beats per minute. The patient was diagnosed as Adams-Stokes syndrome which may be induced by carbamazepinc. She was given an intravenous injection of atropine sulfate 0.5 mg immediately. Then atropine sulfate 1 mg in 5% glucose injection 500 ml was slowly given by intravenous drip. Two hours later, the patient regained consciousness. The electrocardiogram showed restoration of sinus rhythm with a heart rate of 48 beats per minute. Carbamazepine was withdrawn and disturbance of consciousness did not recur.