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Acute topiramate toxicity.

Stephen J Traub¹, Mary Ann Howland, Robert S Hoffman

¹The Division of Toxicology, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Boston, Massachusetts 02215, USA. straub@bidmc.harvard.edu

Journal of Toxicology. Clinical Toxicology

|January 7, 2004

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Acute topiramate (Topamax) toxicity is rare. A 5-year-old girl experienced neurological symptoms like agitation and sensory changes after ingesting the medication, which resolved within 24 hours.

Area of Science:

Neurology
Clinical Toxicology

Background:

Topiramate (Topamax) is an anti-epileptic drug.
Acute toxicity is infrequently reported for topiramate.

Observation:

A 5-year-old girl with no prior topiramate use ingested the medication.
She presented with neurological symptoms including agitation, sensory disturbances, opisthotonos, and perseveration.
Initial diagnostic tests including head CT, EEG, and urine toxicology were unremarkable.

Findings:

Serum topiramate level confirmed acute ingestion (10.5 mcg/mL).
Neurological symptoms resolved completely within a 24-hour observation period.

Implications:

This case highlights the potential for acute neurological toxicity in children following topiramate overdose.

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It underscores the importance of considering topiramate toxicity in the differential diagnosis of unexplained neurological symptoms in children.

Prompt recognition and supportive care can lead to full recovery.