Download PDF
Neuropediatrics 2014; 45(02): 129-131
DOI: 10.1055/s-0033-1360481
Short Communication
Georg Thieme Verlag KG Stuttgart · New York

Everolimus for the Treatment of Subependymal Giant Cell Astrocytoma Probably Causing Seizure Aggravation in a Child with Tuberous Sclerosis Complex: A Case Report

Adelheid Wiemer-Kruel
1   Epilepsy Center Kork, Kehl-Kork, Germany
,
H. Woerle
2   Klinikum Stuttgart, Olgahospital, Stuttgart, Germany
,
K. Strobl
1   Epilepsy Center Kork, Kehl-Kork, Germany
,
T. Bast
1   Epilepsy Center Kork, Kehl-Kork, Germany
› Author Affiliations
Further Information

Publication History

21 March 2013

01 September 2013

Publication Date:
29 November 2013 (online)

Also available at
    Permissions and Reprints

Abstract

We are reporting on a 13.5-year-old girl with tuberous sclerosis complex (TSC) who was treated with everolimus because of giant cell astrocytoma and bilateral angiomyolipoma. She suffered from pharmacoresistant partial epilepsy with clusters of tonic and tonic–clonic seizures. Treatment with carbamazepine and sulthiame had led to a stable situation for more than 2.5 years. The dosage of everolimus had to be increased and refractory status epilepticus followed after 12 days. In the absence of any other possible cause, we believe that the status epilepticus was provoked by everolimus. So far, only a few cases of possible seizure aggravation by everolimus have been reported. The clinical relevance of possible negative effects in epileptic patients remains unclear. Similar observations should be documented and reported.

Keywords

tuberous sclerosis complex - subependymal giant cell astrocytoma - everolimus - seizure aggravation
 

  • References

  • 1 Franz DN, Leonard J, Tudor C , et al. Rapamycin causes regression of astrocytomas in tuberous sclerosis complex. Ann Neurol 2006; 59 (3) 490-498
    CrossrefPubMedSearch in Google Scholar
  • 2 Bebin M, Franz DN, Sahmoud T , et al. Everolimus in Subependymal Giant Cell Astrocytomas (SEGA) Associated with Tuberous Sclerosis Complex (TSC): Results of EXIST-1, a Double-Blind Placebo-controlled Phase III Trial. Eur J Cancer 2011; 47 (Suppl. 02) 4-16
    PubMedSearch in Google Scholar
  • 3 Krueger DA, Care MM, Holland K , et al. Everolimus for subependymal giant-cell astrocytomas in tuberous sclerosis. N Engl J Med 2010; 363 (19) 1801-1811
    CrossrefPubMedSearch in Google Scholar
  • 4 Franz DN, Belousova E, Sparagana S , et al. Efficacy and safety of everolimus for subependymal giant cell astrocytomas associated with tuberous sclerosis complex (EXIST-1): a multicentre, randomised, placebo-controlled phase 3 trial. Lancet 2013; 381 (Issue 9861): 125-132
    CrossrefPubMedSearch in Google Scholar
  • 5 Krueger DA, Wilfong AA, Holland-Bouley K , et al. Everolimus treatment of refractory epilepsy in tuberous sclerosis complex. (e-pub ahead of print) 2013; doi: 10.1002/ana.23960
    PubMed
  • 6 Kotulska K, Chmielewski D, Borkowska J , et al. Long-term effect of everolimus on epilepsy and growth in children under 3 years of age treated for subependymal giant cell astrocytoma associated with tuberous sclerosis complex. EJPN 2013; 17 (5) 479-485
    PubMedSearch in Google Scholar