1.Relief of HHV-6 Encephalomyelitis-induced Electric Shock-like Pain with Levetiracetam after Blood Stem Cell Transplantation
Sunao MARUNAKA ; Yoshie KIMURA ; Kano NISHIUMI ; Junichi IKEGAKI
Palliative Care Research 2021;16(2):209-213
We encountered a case of HHV-6 encephalomyelitis following blood stem cell transplantation. A woman in her 30’s suffered from paroxysmal electric shock-like pain, itching, tremor of lower limbs and excessive sweating on the 15th day after cord blood transplantation. Urinary retention also occurred. Pregabalin and opioid administration was started, and foscarnet was administered after a finding of HHV-6DNA positive in cerebrospinal fluid. Combined use of levetiracetam 1000 mg per day decreased both frequency and intensity of the electric shock-like pain. In a week before the negative results of HHV-6 amplification, she became excessively drowsy. With withdrawal of levetiracetam, her consciousness returned to be clear. The main symptoms on discharge were pain and itching with numbness around the anus, and were well controlled with oxycodone 15 mg, pregabalin 225 mg, and lorazepam 0.5 mg per day. In our case of HHV-6 encephalomyelitis after cord blood transplantation, levetiracetam was effective in suppressing electric shock-like pain.
2.Cases of hypoglycemia in cancer patients taking quetiapine
Yoshie Kimura ; Junichi Ikegaki ; Nobuyasu Komasawa
Palliative Care Research 2013;8(2):566-569
Case: Cancer patients without impaired glucose tolerance developed hypoglycemia during the administration of quetiapine. After increasing the amount of the drug, hypoglycemia was developed in the wake of fasting. Discussion: There is a possibility that quetiapine inhibited the hypoglycemic compensatory reactions during starvation. Conclusion: In cancer patients taking quetiapine, it is necessary to observe the onset of symptoms of hypoglycemia as well as hyperglycemia in mind. And blood glucose measurement on a regular basis is desirable.


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