Topiramate as concomitant antiepileptic treatment; an isolated perioperative hypofibrinogenaemia

Area of Science:

• Neurology
• Hematology
• Clinical Pharmacology

Background:

• Epilepsy is a common neurological disorder requiring long-term management.
• Topiramate is a widely used antiepileptic drug.
• Acquired hypofibrinogenemia is a rare condition characterized by low fibrinogen levels.

Observation:

• A case of isolated hypofibrinogenemia is described.
• The condition was acquired during concomitant treatment with topiramate for drug-resistant epilepsy.
• Hypofibrinogenemia developed within one month of initiating topiramate therapy.

Findings:

• The patient presented with hypofibrinogenemia in the perioperative period.
• The low fibrinogen levels were directly linked to topiramate use.
• This suggests a potential adverse drug reaction affecting coagulation.

Implications:

• Clinicians should be aware of the potential for topiramate to induce hypofibrinogenemia.
• Monitoring fibrinogen levels in patients on topiramate, especially those undergoing surgery, may be warranted.
• This case highlights the importance of considering drug-induced coagulopathies.