Follow-up Case Report: Bumetanide Can Control Seizural Activity in Temporal Lobe Epilepsy Patient

Abstract

Despite the infectiveness of conventional anti-epileptic drugs (AEDs) in refractory focal epilepsy, surgery along with medications, as the only treatment, was not successful in 30% of the cases. Recently, cysto- and histo-physiological investigations revealed the role of gamma-aminobutyric acid (GABA)-ergic system in etiopathology of temporal lobe epilepsy (TLE). Studies reported that the inhibitory action of GABA neurotransmitter due to elevated intracellular Cl-concentration through abnormal expression of Na-K-Cl cotransporter (NKCC)-1 became excessive in recurrent seizures. These primary results were confirmed in the brain tissue obtained from patients with TLE. Based on the evidence, the current study suggested the administration of bumetanide, an NKCC1 inhibitor, as a potential candidate for the treatment of intractable TLE. The previous study by authors showed a significant reduction in seizural activity of 2 out of 3 patients with TLE following the administration of bumetanide. However, result of the current study showed the control of seizure in the 3rd case of previous study by the administration of bumetanide as an adjuvant to AEDs. Moreover, his AEDs dosage after discontinuation of Bumetanide tapered without any relapse.