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Modafinil in Endozepine Stupor. A Case Report

Published online by Cambridge University Press:  02 December 2014

Sharon Scott  and
Iftekhar Ahmed
Sharon Scott
Affiliation:
Department of Family Practice, Trinity Lutheran Hospital, Kansas City, Missouri, USA
Iftekhar Ahmed
Affiliation:
Department of Neurology, Research Medical Center and Department of Neurology, University of Missouri, Kansas City, Missouri, USA
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Abstract

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Background:

Endozepine-4 stupor is a rare disorder. It presents with recurrent episodes of stupor and coma. Endozepine-4 levels are elevated during an attack with electroencephalogram showing fast activity during the ictal phase. There is no specific treatment and various drugs have been tried without long-term benefit.

Method:

We used the vigilance promoting drug modafinil to prevent such attacks in a case presented with endozepine stupor.

Results:

The vigilance promoting drug modafinil prevented recurrent episodes of stupor and coma in this patient at a dose of 200 mg/day for a period of six months. Upon withdrawal of the drug, the patient experienced recurrent episodes and on reinstitution of modafinil she has remained asymptomatic in the following one year.

Type
Editorial
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 3 , August 2004 , pp. 409 - 411
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1.Jasinski, D, Ruzica, M, Listanovic, K.Evaluation of the abuse liability of modafinil and other drugs for excessive daytime sleepiness associated with narcolepsy. Clin Neuropharmacol 2000; 23(3): 149–156.Google Scholar
2.Ferraro, L, Tanganelli, S, O’Connor, WT.The vigilance promoting drug modafinil increases extracellular glutamate levels in the medial preoptic area and the posterior hyothalamus of the conscious rat: prevention by local GABA receptor blockade. Neuropsychopharmacology 1999; 20(4): 346–356.Google Scholar
3.US Modafinil in Narcolepsy Multicenter Study Group. Randomized trial of modafinil as a treatment for the excessive daytime somnolence of narcolepsy. Neurology 2000; (54): 1166–1175.Google Scholar
4.Ferraro, L, Fuxe, K, Tanganelle, S, et al.Amplification of cortical seratonin release: a further neurochemical action of the vigilance-promoting drug modafinil. Neuropharmacology 2000; 39(11): 1974–1983.Google Scholar
5.Azuma, S, Kodernia, T, Honda, K.State dependent changes of extracellular glutamate in the medial area in freely behaving rats. Neurosci Letts 1996; 214: 179–182.Google Scholar
6.Scamelli, TE, Eastabrook, IV, McCarthy, MT.Hypothalamic arousal regions are activated during modafinil-induced wakefulness. J Neurosci 2000; 20(22): 8620–8628.CrossRefGoogle Scholar
7.Lugaresi, E, Montagna, P, Tinupor, P.Endozepine stupor: recurring stupor linked to endozepine-4 accumulation. Brain 1998;121: 127–133.Google Scholar
8.Rothstein, JD, Guido Ai, A, Tinupor, P, et al.Endogenous benzodiazepine receptor ligands in idiopathic recurring stupor. Lancet 1992; 340: 1002–1004.Google Scholar
9.Chen, R, Rothstein, JD, Frey, KA.Idiopathic recurring stupor: a new syndrome. Neurology 1995;45(Suppl 4):A177.Google Scholar
10.Tinupor, P, Montagna, P, Cortelli, P.Idiopathic recurring stupor: a case with possible involvement of the gamma-aminobutyric acid (GABA)ergic system. Ann Neurol 1992; 31(5):503–506.CrossRefGoogle Scholar
11.Lotz, BP, Schutte, CM, Bartel, PR.Recurrent attacks of unconsciousness with diffuse EEG alpha activity. Sleep 1993; 16(7):671–677.Google Scholar
12.Rothstein, JD, Garland, W, Pvia, G, et al.Purification and characterization of naturally occurring benzodiazepine receptor ligands in rat and human brain. J Neurochem 1992; 6(58):2102–2115.Google Scholar