Epileptiform convulsive disorder under chronic meprobamate intoxication

Abstract

The present author has studied from various viewpoints 14 patients who had epileptiform convulsive disorders under chronic Meprobamate intoxication and 47 additional cases which were already reported in Japanese and other languages. There were no specific convulsive predispositions and family histories in the author's cases. Remarkable personality disoders of these cases were often seen in the people who were addicted to any drugs and others. They had no intellectual defects. Generally, convulsive seizure broke out when one took Meprobamate more than 3g daily over one to several years. The present author differentiated four types regarding the occurrence of convulsive seizure as well as the intake of this convulsion precipitated by abrupt withdrawal, convulsion which occurred during intake of this drug, convulsion which occurred under marked consciousness disturbance, and convulsion which occurred particularly during the treatment of marked consciousness disturbance. Clinical types mentioned above were not always the same in one patient. Almost all the convulsive seizures appeared to be of epileptic nature, but they often came out in the form of status epilepticus. Neurological signs and symptoms such as fever, nausea, vomiting, shaking and ataxia would frequently accompany convulsions. Before and after convulsion, there was stormy consciousness disturbance which was certainly different from initial and later twilight state. EEG findings showed convulsive readiness under Meprobamate abuse, so it is quite natural that the convulsive seizure appears even under its abuse. It was not effective to given Meprobamate for the treatment of abstinence syndrome. When convulsion and related disorders hapened to occur, such disorders would reoccur shortly after re-use of Meprobamate. However, if a patient does not fall into abuse again, another convulsive disorder does not occur and clinical outcome is very favourable, so that it is not necessary to prolong anticonvulsant medication.