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Aminopyridine has been shown to improve spasticity and ambulatory speed in patients with multiple sclerosis (MS), spinal cord injuries, and neuromuscular diseases.1–4 Four-aminopyridine (4-AP) selectively blocks fast, voltage-gated potassium channels in excitable tissues and increases the influx of calcium at nerve terminals, thereby enhancing neuromuscular transmission.1 It is this mechanism of action, however, that predispose to adverse events, specifically seizures.1,2,5
Case reports.
In Ontario, Canada, from April 2007 to early May 2007, four patients with secondary progressive MS were admitted to hospital with status epilepticus. Three of the four provided consent for inclusion in this case series. Patients ranged in age from 46 to 54 years with Expanded Disability Status Scale (EDSS) scores of 6.0–6.5 and disease duration of 7–20 years. All had been prescribed 4-AP 10-mg tablets for ambulatory decline at doses between 10 mg BID to TID.
All patients experienced unusual sensory and behavioral symptoms that rapidly transitioned into status epilepticus (recurrent seizures without full …
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