title: Toxic epidermal necrolysis after initiation of felbamate therapy.
abstract: A 33-year-old woman with a 13-year history of partial complex seizures experienced toxic epidermal necrolysis requiring management in a regional burn treatment center after 16 days of single-agent treatment for epilepsy with felbamate 3600 mg/day. Within 24 hours the target lesions involved 45% of her total body surface area. They coalesced and progressed to exfoliation involving the mucosa and the conjunctiva. The patient was hospitalized for 25 days. Reports in the literature describe life-threatening rashes after treatment with felbamate in combination with other anticonvulsant agents. We believe this to be the first reported case of felbamate-induced toxic epidermal necrolysis induced by single-agent therapy. Although felbamate provides many advantages as an anticonvulsant, its structure can be arranged to a conformation in space similar to that of hydantoins and barbiturates, and thus warrants careful patient monitoring for life-threatening rashes.
authors.affiliation: Burn Treatment Center, Crozer-Chester Medical Center, Upland, Pennsylvania, USA.
authors.forename: M T
authors.initials: MT
authors.lastname: Travaglini
authors.forename: R C
authors.initials: RC
authors.lastname: Morrison
authors.forename: B H
authors.initials: BH
authors.lastname: Ackerman
authors.forename: L R
authors.initials: LR
authors.lastname: Haith
authors.forename: M L
authors.initials: ML
authors.lastname: Patton
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D017029:Epilepsy, Complex Partial / Q000188:drug therapy; D000078328:Felbamate; D005260:Female; D006801:Humans; D048448:Phenylcarbamates; D011409:Propylene Glycols / Q000009:adverse effects* / Q000627:therapeutic use; D013262:Stevens-Johnson Syndrome / Q000209:etiology*
chemical_list: D000927:Anticonvulsants; D048448:Phenylcarbamates; D011409:Propylene Glycols; D000078328:Felbamate