Abstracts

We report the largest series of children in a topical/subtropical climate in the United States with transient hypohidrosis and hyperthermia induced by topiramate therapy for partial epilepsy. Overheating and decreased sweating in children during topiramate treatment is a concern due to the potential for high fever, excessive fatigue, severe exercise intolerance, urinary retention and stroke. We report the largest series of seven children, ages 5 to 14 years of age, currently receiving topiramate for partial or mixed epilepsy. Previous cases were reported in Spain in 2001 and 2002 as well as Italy and Israel in 2003. The seven children developed overheating, high temperature and heat intolerance two months to 19 months after topiramate was introduced. Topiramate dosages ranged from 1.8 mg/kg to 6mg/kg. Other medical problems associated with the seven children included one with CP, one with tuberous sclerosis, one with VPS, one with ADHD and one with headaches. Signs and symptoms subsided after drug cessation and/or decrease in dose. Three children were transitioned to other AED[apos]s and the other four received decreased dosage. None of the children developed increase in seizure episodes. There is a increased occurrence of hypohidrosis and hyperthermia associated with topiramate treatment in children with seizures living in warmer climates in the U.S. Closely monitoring for evidence of decreased sweating and increased body temperature as well as proper hydration before and during outdoor activity is recommended.