Journal of Child Neurology

 

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First published on March 14, 2008
Journal of Child Neurology 2008, doi:10.1177/0883073808314156

Article

Simultaneous Toxicities in a Child on Multiple Anticonvulsants

Sarah Isis R. Delima, Laurence E. Walsh, MD, and Meredith R. Golomb, MD, MSc*

Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis

* To whom correspondence should be addressed. E-mail: mgolomb{at}iupui.edu.


  Abstract
It is rare to develop simultaneous toxicities while on anticonvulsants. This article presents a 31/2-year-old child on valproic acid, lamotrigine, and phenytoin who developed simultaneous hepatotoxicity and bone marrow toxicity during a parainfluenza virus type 3 infection. These toxicities resolved after the cessation of anticonvulsants, and her seizures were managed acutely with scheduled lorazepam. This article discusses the possibility that simultaneous use of valproic acid, lamotrigine, and phenytoin could give this combination of toxicities and that concurrent viral infection may increase this risk.


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