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Signs and symptoms of carbamazepine overdose in young children

M Lifshitz1, V Gavrilov, S Sofer

  • 1Toxicology Unit, Soroka University Medical Center, Beer-Sheva, Israel. matyl@bgumail.bgu.ac.il

Pediatric Emergency Care
|March 4, 2000
PubMed

Insights

In young children, nystagmus is the most common sign of carbamazepine (CBZ) overdose, often accompanied by drowsiness or ataxia. This finding aids in diagnosing CBZ toxicity in pediatric patients with unknown central nervous system depression.

Area of Science:

  • Pediatric Toxicology
  • Clinical Pharmacology
  • Emergency Medicine

Background:

  • Accidental carbamazepine (CBZ) poisoning is a concern in young children.
  • Identifying early signs of mild to moderate CBZ overdose is crucial for timely intervention.

Purpose of the Study:

  • To identify and describe the common clinical manifestations of mild to moderate carbamazepine (CBZ) overdose in pediatric patients.
  • To establish key diagnostic indicators for carbamazepine toxicity in young children.

Main Methods:

  • Retrospective analysis of medical records of children under 5 years with acute accidental CBZ poisoning.
  • Evaluation of serum CBZ levels, clinical signs and symptoms, and laboratory findings.
  • Data collected from pediatric admissions between 1993 and 1998.

Main Results:

  • 14 children under 5 years experienced accidental CBZ poisoning.
  • Nystagmus (8/14) and drowsiness (8/14) were the most frequent signs, followed by ataxia (4/14).
  • Peak serum CBZ levels ranged from 18 to 32 microg/ml (mean 25 microg/ml), significantly above the therapeutic range (5-10 microg/ml).

Conclusions:

  • Nystagmus is the most common presenting sign of mild to moderate carbamazepine overdose in young children.
  • Drowsiness and ataxia are also frequent symptoms associated with pediatric CBZ toxicity.
  • The presence of nystagmus and central nervous system depression of unknown origin in a child warrants consideration of carbamazepine poisoning.
Abstract

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