Epilepsy triggered by mefloquine in an adult traveler to Uganda  

作　　者：Federico Gobbi Andrea Rossanese Dora Buonfrate Andrea Angheben Chiara Postiglione Zeno Bisoffi 

机构地区：[1]Department of Tropical Diseases, Sacro Cuore-Don Calabria Hospital, 37024 Verona, Italy [2]Prevention Department, ULSS 20 Verona, 37122 Verona, Italy

出　　处：《World Journal of Clinical Cases》2014年第1期12-15,共4页世界临床病例杂志

摘　　要：We report a case of a traveler who visited Uganda for 8 d, and took mefloquine one tablet/week for malaria prophylaxis. After the second dose, he suffered from two episodes of loss of consciousness with seizures, therefore mefloquine was discontinued. During the flight back after full recovery, seizures reoccurred while he was on board, he was disembarked in Addis Ababa and then transferred to Nairobi. After repatriation to Italy, he experienced four other similar episodes. The patient was still on full dose anticonvulsant therapy one year and a half after, as any attempt at reduced dose was unsuccessful. Currently, three agents(mefloquine, atovaquone/proguanil, and doxycycline) are recommended for malaria chemoprophylaxis, with similar efficacy but different adverse event profiles, regimens, and prices. Considering that mefloquine is associated with a higher risk of neurologic and psychiatric adverse events than the alternative regimens, we suggest considering mefloquine as a second line choice after atovaquone/progua-nil and doxycycline for short-term travelers.We report a case of a traveler who visited Uganda for 8 d, and took mefloquine one tablet/week for malaria prophylaxis. After the second dose, he suffered from two episodes of loss of consciousness with seizures, therefore mefloquine was discontinued. During the flight back after full recovery, seizures reoccurred while he was on board, he was disembarked in Addis Ababa and then transferred to Nairobi. After repatriation to Italy, he experienced four other similar episodes. The patient was still on full dose anticonvulsant therapy one year and a half after, as any attempt at reduced dose was unsuccessful. Currently, three agents(mefloquine, atovaquone/proguanil, and doxycycline) are recommended for malaria chemoprophylaxis, with similar efficacy but different adverse event profiles, regimens, and prices. Considering that mefloquine is associated with a higher risk of neurologic and psychiatric adverse events than the alternative regimens, we suggest considering mefloquine as a second line choice after atovaquone/progua-nil and doxycycline for short-term travelers.

关 键 词：MEFLOQUINE NEUROPSYCHIATRIC disorders EPILEPSY ANTIMALARIAL CHEMOPROPHYLAXIS Side effects 

分 类 号：R742.1[医药卫生—神经病学与精神病学]