601
Views
9
CrossRef citations to date
0
Altmetric
Reviews

Rhabdomyolysis induced by antiepileptic drugs: characteristics, treatment and prognosis

, &
Pages 357-365 | Received 30 Sep 2015, Accepted 05 Jan 2016, Published online: 20 Feb 2016
 

ABSTRACT

Introduction: Rhabdomyolysis syndrome refers to a variety of factors that affect the striated muscle cell membrane, the membrane channels and its energy supply. Most cases of rhabdomyolysis are due to direct trauma. However, infection, toxins, drugs, muscle ischemia, electrolyte imbalance, metabolic diseases, genetic diseases and abnormal body temperature can also lead to rhabdomyolysis. Epilepsy is one of the most common chronic neurological diseases. The primary long-term treatment is antiepileptic drugs (AEDs), which may cause rhabdomyolysis. This article summarizes the characteristics, treatment methods and prognosis of patients with rhabdomyolysis that is induced by antiepileptic drugs.

Areas covered: This review is based on PubMed, EMBASE and MEDLINE searches of the literature using the keywords “epilepsy”, “antiepileptic drugs”,“status epilepticus”,“rhabdomyolysis”, and “antiepileptic drugs and rhabdomyolysis syndrome” as well as extensive personal clinical experience with various antiepileptic drugs. Potential relationships between antiepileptic drugs and rhabdomyolysis are discussed.

Expert opinion: Worldwide, there are approximately 50 million epilepsy patients, most of whom are treated with drugs. Reports have indicated that the majority of antiepileptic drugs on the market can cause rhabdomyolysis. Although rhabdomyolysis induced by antiepileptic drugs is a rare condition with a low incidence, this condition has serious consequences and merits attention from clinicians.

Article highlights

  • Rhabdomyolysis is a muscle disorder involving the rapid dissolution of skeletal muscle cells.

  • The typical symptoms of rhabdomyolysis include acute or subacute myalgia, muscle weakness, and urinary pigmentation, which together are termed the rhabdomyolysis syndrome triad.

  • Although antiepileptic drugs have been well studied, the current treatment of epilepsy drugs remains based on the long-term administration of these medications. Given the side effects of various antiepileptic drugs, the improper administration of these medications can seriously affect patients’ quality of life.

  • The primary drugs that induce rhabdomyolysis include statins, other lipid-lowering drugs, and psychotropic substances. Rhabdomyolysis caused by antiepileptic drugs has recently become an issue.

  • A diagnosis of rhabdomyolysis can be confirmed by examining the causes of a patient’s condition; the patient’s symptoms; and findings from laboratory tests, imaging studies, and muscle biopsies.

  • Acute treatment should focus on protecting renal function and correcting the metabolic disorders and acidosis.

This box summarizes key points contained in the article.

Declaration of Interest

The author has no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.