A Case of Vigabatrin Induced Symptomatic Visual Field Defect

J Korean Neurol Assoc > Volume 18(2); 2000 > Article

Journal of the Korean Neurological Association 2000;18(2): 232-234.

Vigabatrin에 의한 증후성 시야결손 1예

엄근용, 김성민이이병주이송홍기이권기한이이병철이오진석*이이경화

한림대학교 의과대학 신경과학교실,안과학교실

A Case of Vigabatrin Induced Symptomatic Visual Field Defect

Keun-Yong Uhm, M.D., Sung-Min Kim, M.D., Byung-Ju Lee, M.D., Hong-Ki Song, M.D., Ki-Han Kwon, M.D., Byung-Chul Lee, M.D., Jin-Soek Oh, M.D.*, Kyung-Hwa Lee, M.D.*

Department of Neurology and Ophthalmology*, Hallym University College of Medicine

Abstract

Vigabatrin (VGB) is one of the most frequently prescribed new anti-epileptic drugs in the world since 1989. It has minimal side effects and fewer drug interactions with other anti-epileptic drugs. Recently, concern of the prevalence and pathophysiology of visual impairment with VGB has been increased since the reports of visual field constriction in patients treated with VGB. We report a 46-year-old man with a visual field defect who has been suffering from com-plex partial seizures for 29 years. Brain magnetic resonance image (MRI) and electroencephalogram (EEG) were non-specific. The frequency of seizures was about 5 times a month for the past 5 years. VGB, in a dose of 1500 mg/day, was prescribed as an add on drug in addition to carbamazepine. 19 months after VGB treatment, the patient complained of visual dimness especially in the lower half of the visual field. He expressed it as “waving”. He had no metabolic derangement. Fundus examination, visual evoked potential, and electroretinogram showed normal findings. A visual field analysis showed a bilateral field defect in the lower half. A follow up visual field analysis, 6 months after the withdrawal of VGB, revealed a slight improvement of visual field defects which were noted without significant clinical improvement. This case implicates that visual field defects due to VGB may be partially reversible. J Korean Neurol Assoc 18(2):232~234, 2000 Key Words : Vigabatrin, Visual field defect, Reversible