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Rash and edema shortly after initial exposure to low dose cenobamate.
Christopher Saouda1, Yamane Makke1, Helen Edelberg1
1Department of Neurology, George Washington University, Washington, DC, USA.
Epilepsy & Behavior Reports
|July 18, 2025
Summary
Cenobamate (CNB), an antiseizure medication for focal epilepsy, can cause uncommon skin reactions. Two patients experienced facial and chest rash and edema after starting CNB, resolving upon discontinuation.
Area of Science:
- Neurology
- Dermatology
Background:
- Cenobamate (CNB) is an approved antiseizure medication (ASM) for treating focal epilepsy.
- Adverse effects like rash and edema are considered uncommon with CNB therapy.
Observation:
- Two patients with medically refractory epilepsy (MRE) were initiated on CNB at a low dose (12.5 mg/d).
- Both patients developed distinct chest and facial rash and edema shortly after the initial CNB dose.
Findings:
- Discontinuation of CNB led to the resolution of the observed rash and edema in both patients.
- Re-administration of CNB in one patient reproduced the adverse skin reactions, confirming a causal link.
Implications:
- This case report highlights the potential for cenobamate to induce uncommon dermatological adverse events, including rash and edema.
- Increased clinical awareness of these specific CNB reactions is crucial for timely diagnosis and management in patients with epilepsy.
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