Carbamazepine Toxicity Masquerading as Complex Febrile Seizures in a Pediatric Patient

Area of Science:

• Pediatric Neurology
• Clinical Toxicology

Background:

• Carbamazepine is an antiepileptic medication.
• Carbamazepine overdose can induce seizure-like activity.
• Overdoses may be misdiagnosed as primary seizure disorders.

Observation:

• A 20-month-old female presented with fever and seizure-like activity.
• Initial diagnosis considered complex febrile seizures.
• Elevated carbamazepine level (29 mcg/ml) was detected.

Findings:

• Multidose activated charcoal administration led to a downtrend in carbamazepine levels.
• The patient's condition improved significantly.
• No permanent neurological deficits were observed upon discharge.

Implications:

• Xenobiotic exposure, even without clear historical indicators, should be considered in differential diagnoses.
• Early identification of drug toxicity is crucial for timely and effective treatment.
• This case underscores the importance of toxicology screening in patients presenting with unexplained neurological symptoms.