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Pediatric case report of topiramate toxicity

George Lin1, Ruth Lawrence

  • 1Finger Lakes Regional Poison and Drug Information Center, University of Rochester Medical Center, Rochester, New York, USA. George_Lin@urmc.rochester.edu

Clinical Toxicology (Philadelphia, Pa.)
|February 25, 2006
PubMed

Insights

Acute topiramate ingestion in a toddler caused prolonged neurologic symptoms, including hallucinations and ataxia. This case highlights potential pediatric toxicity risks associated with this antiepileptic medication.

Area of Science:

  • Pediatric Neurology
  • Clinical Toxicology
  • Pharmacology

Background:

  • Topiramate is an FDA-approved antiepileptic drug with complex mechanisms of action.
  • Previous pediatric topiramate toxicity reports are limited.
  • This study details a rare case of acute topiramate ingestion in a young child.

Observation:

  • A 33-month-old girl presented with confusion, crawling mobility, visual hallucinations, slurred speech, and severe ataxia three days after ingesting topiramate.
  • Neurological examination revealed significant motor and cognitive deficits.
  • Despite normal laboratory tests, elevated topiramate levels were detected days post-ingestion.

Findings:

  • The patient experienced persistent neurological symptoms, including hallucinations and ataxia, lasting several days.
  • Slurred speech resolved by day six post-ingestion.
  • This is the first reported pediatric case of topiramate-induced hallucinations and prolonged neurological symptoms.

Implications:

  • This case underscores the potential for severe and prolonged neurological toxicity in children following acute topiramate overdose.
  • It highlights the importance of considering topiramate toxicity in pediatric patients presenting with unexplained neurological symptoms.
  • Further research into pediatric topiramate pharmacokinetics and toxicity is warranted.
Abstract

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