A 33-year-old patient with human immunodeficiency virus on antiretroviral therapy with efavirenz-induced complex partial seizures: a case report

Details

• Alternative Title:
  J Med Case Rep
• Personal Author:
  Shehu, Nathan Yakubu ; Ojeh, Victor ; Osaigbovo, Godwin ; Agaba, Patricia ; Agbaji, Oche
• Description:
  Background
  
  Efavirenz is a commonly prescribed antiretroviral drug that is largely well tolerated. However, seizure disorder is a rare side effect. Prompt identification and immediate replacement of efavirenz with an alternative drug would effectively stop the seizures. To the best of our knowledge, we present the first reported case in the literature of complex partial seizures arising due to efavirenz.
  
  Case presentation
  
  We report a case of a 33-year-old Nigerian man treated with an efavirenz-based antiretroviral regimen for human immunodeficiency virus infection. He presented with seizures soon after commencement of antiretroviral drugs. His magnetic resonance imaging results were unremarkable. His blood levels of sodium, glucose, urea, and creatinine were within normal limits. However, his electroencephalogram showed intermittent bursts of high-voltage sharp waves and spikes bilaterally over frontotemporoparietal regions, a finding consistent with complex partial seizures. His efavirenz plasma level was 209.55 μg/ml. His seizures stopped following a switch to a non-efavirenz-based regimen.
  
  Conclusions
  
  This report brings to light the occurrence of complex partial seizures in patients on efavirenz. It also demonstrates the effective resolution of seizures when efavirenz treatment is replaced with a non-efavirenz-based regimen.
  
  
• Subjects:
  Case Report Efavirenz HIV Seizures
• Source:
  J Med Case Rep. 10.
• Pubmed ID:
  27072009
• Pubmed Central ID:
  PMC4830054
• Document Type:
  Journal Article
• Funding:
  PS 001058/PS/NCHHSTP CDC HHS/United States ; U51HA02522/PHS HHS/United States
• Volume:
  10
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:39c734a19252301016a3b3765d7e848944780215be4a993ebf58ab42cef19fda
• Download URL:
  https://stacks.cdc.gov/view/cdc/41021/cdc_41021_DS1.pdf
• File Type:
  [PDF - 1.12 MB ]