1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-9-18-b 10.15844/pedneurbriefs-9-3-3 Seizure Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Theophylline-Induced Infantile Spasms http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 03 1995 01 06 2016 9 3 18 19 Copyright: © 1995 The Author(s) 1995 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Infantile spasms associated with theophylline toxicity

Infantile spasms and hypsarrhythmia developed in a 6-month-old infant with asthma after 3 days treatment with theophylline at the Royal Belfast Hospital for Sick Children, Northern Ireland.

 Therapeutic Level Theophylline Blood Level Hypsarrhythmia

Infantile spasms and hypsarrhythmia developed in a 6-month-old infant with asthma after 3 days treatment with theophylline at the Royal Belfast Hospital for Sick Children, Northern Ireland. Theophylline blood level was elevated to 108 mcmol/1 (30 mcmol above therapeutic level). Spasms stopped and EEG became normal when nitrazepam was started and theophylline was discontinued. Nitrazepam was withdrawn at 10 months, the sleep EEG was normal at 14 months, and seizures had not recurred at 3 year follow-up. [1]

COMMENT. A direct causal relationship was considered probable because of the close temporal association of spasms and a toxic level of theophylline and the complete remission when the drug was discontinued. A dose of 6-8 mg/kg/day theophylline is usually recommended for infants <7 months of age with asthma. The toxic dose in this patient was 16 mg/kg/day.

Infantile spasms in 5 children (4 symptomatic) persisted to 5 to 14 years of age in a report from the Steele Memorial Children’s Research Center, University of Arizona, Tucson. [2]

 Shields MD Hicks EM Macgregor DF Richey S Infantile spasms associated with theophylline toxicity Acta Paediatr 1995 Feb 84 2 215 7 7756814 10.1111/j.1651-2227.1995.tb13615.x Talwar D Baldwin MA Hutzler R Griesemer DA Epileptic spasms in older children: persistence beyond infancy Epilepsia 1995 Feb 36 2 151 5 7821272 10.1111/j.1528-1157.1995.tb00974.x