Cerebellar atrophy does not increase susceptibility to carbamazepine toxicity

Cerebellar atrophy (CA) is a frequent finding in patients with chronic epilepsy. To find out whether the existence of CA has an influence on the tolerance of high-dose monotherapy with carbamazepine, we compared the lowest individual toxic serum levels in patients with complex focal seizures, with CA (n = 27) and without CA (n = 20) in computerized tomography (CT). There was no statistical difference between the groups, even after separating patients with mild CA (n = 20) from those with more severe damage (n = 7). In addition, other clinical, EEG and CT data also seemed to have no influence on the individual toxic threshold serum levels of carbamazepine.