γ-Benzene Hexachloride造成癲癇發作

701 1

-Benzene Hexachloride

-Benzene hexachloride

-benzene hexachloride 1% cream

( Scabies )

-Benzene hexachloride ( -BHC ) ( Adverse effect )

( Seizure )

Sarcoptes scabiei

( ectoparasitic )

- Benzene hexachloride ( -BHC ) 1948

( seizure )

-BHC

7 5 1 6 0

3 6 . 7

7 6

9 3 2

phenytoin 100 mg

Sarcoptes scabiei

93 12 9 4 3 2 2

-BHC 1%

cream urea cream hydrocortisone ointment 3 3 0

-BHC cream 3

31 ceftriaxone 4 1

vancomycin 4 7

-BHC cream 4 11

diazepam 5 mg

diazepam 5 mg phenytoin 500

mg phenytoin 100 mg

-BHC

( en-

cephalomalacia ) ( cran-

iotomy ) 4 12

phenytoin 300 mg

4 1 4

-BHC

1948

2

3

1953 -B-

HC -B-

H C

2

3

-BHC

13%

Milton Tenenbein

-BHC 19

( ) -BHC 1 8

19 7 -

BHC 2.8 ng/mL

9.3 ng/mL

-BHC 72

10.3 ng/mL

21~26

7 0 . 6

ng/mL -BHC

1 )

-BHC 2 )

3 ) - B -

HC -BHC

-BHC

-BHC

7

crotamiton

-BHC

-BHC 100 ng/mL 5 ng/mL

-BHC

8

-BHC

8.5

-BHC 36

48

-BHC

9

- B H C

1 6 0 3 6 . 7

Milton Tenenbein

1 8

-BHC

-BHC

-BHC -B-

H C

N a

/ K

AT P a s e -

aminobutyric acid ( GABA )

Dorothy Woolley

-BHC

G A B A diazepam

diazepam GABA

-BHC

GABA -

B H C

2

-BHC

7 8 9 9 9

18 4 7 75

160 36.7

1% -BHC 1% -BHC 1% -BHC -BHC -BHC 1% -BHC

- 9 4 3 2 2

3 30

4 7

- 24 - 36-40 - -

8.5 48 - 9 4 4 1 1

-BHC 50 10 ng/mL 100 ng/mL - - - -

( ( 46 )

)

9.3%

-BHC

11

-

B H C

-BHC 3.3 ( 110

ppb/33.3 ppb ) 53

-BHC -BHC

330 ppb

-BHC

90 g/dL

9 3 2

phenytoin 12

13

1 2

14

-BHC

- B H C

permethrin -BHC

-BHC permethrin

15

-BHC

16

-BHC

-BHC -BHC

8~12 -BHC

- B H C

- B H C

-benzene hexachloride 85-98%

Permethrin -BHC -BHC

Crotamiton -BHC

Benzyl benzoate -BHC

Ivermectin -BHC

50 -BHC

-BHC

-BHC

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-Benzene Hexachloride Induced Seizure A Case Report

Chun-Nan Kuo, Wen-Liang Lin

, Chia-Ming Chang

, Wen-Chien Ko

, Hsin-Chun Lee

, Nan-Yao Lee

, Chin-Wei Huang

, and Yea-Huei Kao Yang

Scabies is an infectious disease caused by There are three hundred million cases around the world every year. -Benzene hexachloride ( -BHC) is a scabicide used to treat the disease. Adverse ef- fects associated with -BHC include dermatitis, numbness, anxiety, tremor, cramps, seizure, aplastic anemia and pancytopenia. Seizure is a serious one among these. We report a 75-year-old woman who suffered from scabies, which was diagnosed one week before this admission and -BHC cream was prescribed. Because of fever and hypotention during hemodialysis, she was admitted and -BHC was used twice during admission.

Seizure occurred 4 days after the last use of -BHC. We reviewed the literatures and discussed the predispos- ing factors and the possible mechanism of -BHC induced seizure. The correct method of using -BHC is re- emphasized and clinicians should be cautious when prescribing it. ( J Intern Med Taiwan 2007; 18: 152-157 )

Institute of Clinical Pharmacy, Medical College, National Cheng Kung University,

1

Department of Pharmacy,

2

Division of Infectious Disease, Department of Internal Medcine,

3

Department of Neurology, National Cheng Kung University Hospital, Tainan, Taiwan

Sarcoptes scabiei.