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Valproic Acid 투여로 인한 약인성 떨림 환자의 한방 치료 치험 1례

A Case Report of Valproic Acid-Induced Tremor by Korean Traditional Medicine

  • 장한솔 (동국대학교 분당한방병원 한방내과) ;
  • 하유빈 (동국대학교 분당한방병원 한방내과) ;
  • 정승현 (동국대학교 분당한방병원 한방내과)
  • Jang, Hansol (Dept. of Korean Internal Medicine, Dongguk University Budang Korean Medicine Hospital) ;
  • Ha, Yu-bin (Dept. of Korean Internal Medicine, Dongguk University Budang Korean Medicine Hospital) ;
  • Jung, Seung-hyun (Dept. of Korean Internal Medicine, Dongguk University Budang Korean Medicine Hospital)
  • 투고 : 2021.11.26
  • 심사 : 2021.12.31
  • 발행 : 2021.12.30

초록

A 56-year-old male patient with a sudden onset of tremor and involuntary movement of right upper and lower extremities, head, and voice was diagnosed as having a drug-induced tremor, with valproic acid being the culprit drug. The patient had undergone admission treatment at an internal Korean medicine department with herbal medicine according to constitutional diagnosis, acupuncture, moxibustion, cupping, and rehabilitation. The change in the severity of tremor was assessed with the Fahn Tolosa Marine scale. After discharge, the patient took herbal medicine for two more months. After 20 days of admission and 2 months of treatment with herbal medicine, the patient's tremor improved. In this case, the patient with valproic acid-induced tremor showed improvement in symptoms after 20 days of hospitalization and further reduction of tremor and improvement of quality of life were confirmed through follow-up for 2 months.

키워드

참고문헌

  1. Chateauvieux S, Morceau F, Dicato M, Diederich M. Molecular and therapeutic potential and toxicity of valproic acid. J Biomed Biotechnol 2010;2010:479364. https://doi.org/10.1155/2010/479364
  2. Lee JH, Jo WH, Park PK, Kim JH, Jang WY, Kim HY, et al. A Survey of the Use of Antiepileptic Drugs in Stroke Patients. J Korean Neurol Assoc 2013;31(2):101-7.
  3. Perucca E. Pharmacological and therapeutic properties of valproate: a summary after 35 years of clinical experience. CNS Drugs 2002;16(10):695-714. https://doi.org/10.2165/00023210-200216100-00004
  4. Aronson JK. Meyler's Side Effects of Drugs: The International Encyclopedia of Adverse Drug Reactions and Interactions. 16th edition. Amsterdam: Elsevier; 2016, p. 303-37.
  5. Morgan JC, Kurek JA, Davis JL, Sethi KD. Insights into Pathophysiology from Medication-induced Tremor. Tremor Other Hyperkinet Mov(NY) 2017;7:442. https://doi.org/10.5334/tohm.374
  6. Morgan JC, Sethi KD. Drug-induced tremors. Lancet Neurol 2005;4(12):866-76. https://doi.org/10.1016/S1474-4422(05)70250-7
  7. Zadikoff C, Munhoz RP, Asante AN, Politzer N, Wennberg R, Carlen P, et al. Movement disorders in patients taking anticonvulsants. J Neurol Neurosurg Psychiatry 2007;78(2):147-51. https://doi.org/10.1136/jnnp.2006.100222
  8. Zhang CQ, He BM, Hu ML, Sun HB. Risk of Valproic Acid-Related Tremor: A Systematic Review and Meta-Analysis. Front Neurol 2020;11:576579. https://doi.org/10.3389/fneur.2020.576579
  9. Silver M, Factor SA. Valproic acid-induced parkinsonism: levodopa responsiveness with dyskinesia. Parkinsonism Relat Disord 2013;19(8):758-60. https://doi.org/10.1016/j.parkreldis.2013.03.016
  10. Jankovic J, Tolosa E. Parkinson's disease and movement disorders. 2nd ed. Baltimore: Williams and Wilkins; 1993, p. 271-80.
  11. Elble R, Bain P, Forjaz MJ, Haubenberger D, Testa C, Goetz CG, et al. Task force report: scales for screening and evaluating tremor: critique and recommendations. Mov Disord 2013;28(13):1793-800. https://doi.org/10.1002/mds.25648
  12. Zelano J, Holtkamp M, Agarwal N, Lattanzi S, Trinka E, Brigo F. How to diagnose and treat post-stroke seizures and epilepsy. Epileptic Disord 2020 Jun 1;22(3):252-63. https://doi.org/10.1684/epd.2020.1159
  13. Culpepper L, Wingertzahn MA. Over-the-Counter Agents for the Treatment of Occasional Disturbed Sleep or Transient Insomnia: A Systematic Review of Efficacy and Safety. Prim Care Companion CNS Disord 2015;17(6):10.4088/PCC.15r01798.
  14. Monti JM, Monti D. Histamine H 1 receptor antagonists in the treatment of insomnia. CNS drugs 2000;13(2):87-96. https://doi.org/10.2165/00023210-200013020-00002
  15. Zlott DA, Byrne M. Mechanisms by which pharmacologic agents may contribute to fatigue. PM&R 2010;2(5):451-5. https://doi.org/10.1016/j.pmrj.2010.04.018
  16. Sweetman S. Martindale: The Complete Drug Reference. 36th edition. London: Pharmaceutical Press; 2009, p. 561, 577.
  17. Scharman EJ, Erdman AR, Wax PM, Chyka PA, Caravati EM, Nelson LS, et al. Diphenhydramine and dimenhydrinate poisoning: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol 2006;44(3):205-23. https://doi.org/10.1080/15563650600585920
  18. Kuo CC, Huang RC, Lou BS. Inhibition of Na(+) current by diphenhydramine and other diphenyl compounds: molecular determinants of selective binding to the inactivated channels. Mol Pharmacol 2000;57(1):135-43.
  19. Heo K. New antiepileptic drugs. J Korean Med Assoc 2012;55(2):155-73. https://doi.org/10.5124/jkma.2012.55.2.155
  20. World Health Organization (WHO). The use of the WHO- UMC system for the standardized case causality assessment. 2013. [online][cited on Nov. 19 2021]. Available from: https://www.who.int/medicines/areas/quality_safety/safety_efficacy/WHOcausality_assessment.pdf
  21. Edwards IR, Aronson JK. Adverse drug reactions: definitions, diagnosis, and management. Lancet 2000;356(9237):1255-9. https://doi.org/10.1016/S0140-6736(00)02799-9
  22. Masmoudi K, Gras-Champel V, Masson H, Andrejak M. Parkinsonism and/or cognitive impairment with valproic acid therapy: a report of ten cases. Pharmacopsychiatry 2006;39(1):9-12. https://doi.org/10.1055/s-2006-931471
  23. Farkas Z, Gulyas S, Molnar R, Szirmai I, Kamondi AJS. Quantitative analysis of motor performance in epilepsy patients treated with valproate. Seizure 2010;19(3):173-7. https://doi.org/10.1016/j.seizure.2010.01.013
  24. Spisak T, Roman V, Papp E, Kedves R, Saghy K, Csol e CK, et al. Purkinje cell number-correlated cerebrocerebellar circuit anomaly in the valproate model of autism. Sci Rep 2019;9(1):9225. https://doi.org/10.1038/s41598-019-45667-1
  25. Li Y, Zhou Y, Peng L, Zhao Y. Reduced protein expressions of cytomembrane GABAARβ3 at different postnatal developmental stages of rats exposed prenatally to valproic acid. Brain Res 2017;1671:33-42. https://doi.org/10.1016/j.brainres.2017.06.018
  26. Paparella G, Angelini L, De Biase A, Cannavacciuolo A, Colella D, Di Bonaventura C, et al. Clinical and Kinematic Features of Valproate-Induced Tremor and Differences with Essential Tremor. Cerebellum. 2021;20(3):374-83. https://doi.org/10.1007/s12311-020-01216-5
  27. Lee JM. Donguisusebowon (Constitutional Medicine in the East). Seoul: Yeokang Publishing; 1992, p. 74-164.
  28. Kim JH, Song JM. A Study about modification of Gejitang that showed on symptom and prescription about Soumin. J Sasang Constitut Med 1999;11(1):201-20.