Supplementary Material for: Hyponatremia-induced epileptic seizure provoked by levetiracetam and pain medication intake in a patient with central diabetes insipidus

Introduction: Causes of epileptic seizures are often multifactorial but for an effective therapy they should be uncovered in detail.
Case presentation: We present a 67-year old male patient with a central diabetes insipidus, who experienced a generalized tonic-clonic seizure. The patient was treated with levetiracetam for prevention of further seizures, opioids and non-steroidal anti-inflammatory drugs [NSAID], i.e. ibuprofen because of severe back pain due to vertebral compression fractures. In this setting, he developed significant hyponatremia and experienced another epileptic seizure. After stopping analgesics and switching from levetiracetam to lacosamide, sodium levels returned to normal and the patient remained free of seizures since then.
Conclusion The interrelationships of medical therapy, sodium levels and epileptic seizures in the context of central diabetes insipidus are discussed.

引言：癫痫发作的病因往往具有多因素性，但为实现有效治疗，需对其进行详尽探明。
病例报告：本文报告1例67岁男性中枢性尿崩症（central diabetes insipidus）患者，曾出现全面性强直-阵挛发作（generalized tonic-clonic seizure）。患者因预防癫痫再发接受左乙拉西坦（levetiracetam）治疗，同时因椎体压缩性骨折引发的剧烈背痛，联用阿片类药物与非甾体抗炎药（non-steroidal anti-inflammatory drugs, NSAID）——即布洛芬（ibuprofen）。在此治疗背景下，患者出现显著低钠血症（hyponatremia），并再次发生癫痫发作。停用镇痛药物并将左乙拉西坦更换为拉考沙胺（lacosamide）后，患者血钠水平恢复正常，且此后未再出现癫痫发作。
结论：本文探讨了中枢性尿崩症背景下，药物治疗、血钠水平与癫痫发作三者之间的相互关联。