Heat stroke-like episode in a child caused by zonisamide

A 2-year-old mentally retarded boy with frontal lobe epilepsy presented with an episode that resembled heat stroke during the administration of zonisamide. He developed hyperpyrexia with oligohidrosis and central neurological symptoms, including, chorea-like involuntary movements, resting tremor, an...

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Bibliographic Details
Published in:Brain & development (Tokyo. 1979) 1997-07, Vol.19 (5), p.366-368
Main Authors: Shimizu, Toko, Yamashita, Yushiro, Satoi, Mika, Togo, Akiko, Wada, Naoko, Matsuishi, Toyojiro, Ohnishi, Akio, Kato, Hirohisa
Format: Article
Language:English
Subjects:
Anticonvulsants - adverse effects
Biological and medical sciences
Biopsy
Child, Preschool
Drug toxicity and drugs side effects treatment
Epilepsy - drug therapy
Fever - chemically induced
Fever - etiology
Fever - physiopathology
Heat stroke
Heat Stroke - chemically induced
Heat Stroke - complications
Heat Stroke - physiopathology
Humans
Hypohidrosis - chemically induced
Hypohidrosis - etiology
Hypohidrosis - physiopathology
Isoxazoles - adverse effects
Male
Medical sciences
Oligohidrosis
Pharmacology. Drug treatments
Skin - pathology
Toxicity: nervous system and muscle
Zonisamide
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Summary:A 2-year-old mentally retarded boy with frontal lobe epilepsy presented with an episode that resembled heat stroke during the administration of zonisamide. He developed hyperpyrexia with oligohidrosis and central neurological symptoms, including, chorea-like involuntary movements, resting tremor, and cogwheel rigidity. A sweat test using pilocarpine iontophoresis revealed a marked reduction in the sweat response, which suggested a postganglionic sweating dysfunction. A skin biopsy examined by light and electron microscopy showed no morphological abnormality in the sweat glands. The oligohidrosis caused by zonisamide was reversible in that the patient regained the ability to sweat within 2 weeks of the cessation of drug administration. Children receiving zonisamide should be monitored for oligohidrosis and the development of neurological symptoms associated with an elevation of body temperature.
ISSN:0387-7604
1872-7131
DOI:10.1016/S0387-7604(97)00029-6