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Journal of Child Neurology
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Simultaneous Toxicities in a Child on Multiple Anticonvulsants

Sarah Isis R. Delima

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

Laurence E. Walsh, MD

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

Meredith R. Golomb, MD, MSc

Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, mgolomb{at}iupui.edu

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.

Key Words: hepatotoxicity • bone marrow • epilepsy

This version was published on September 1, 2008

Journal of Child Neurology, Vol. 23, No. 9, 1054-1057 (2008)
DOI: 10.1177/0883073808314156
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