Anticonvulsants and neurogenic pulmonary edema

A patient with a seizure disorder since childhood was poorly compliant with anticonvulsant medication. He died suddenly following a seizure secondary to a rapid decrease in plasma anticonvulsant drug levels. Autopsy demonstrated pulmonary edema. This noncardiac form of pulmonary edema has been related to low anticonvulsant drug levels in many epileptics who die suddenly. Patients receiving anticonvulsant medication must make no change in drug dosage without medical guidance because of the risk of this catastrophic consequence.