Electrophysiological study in 2 children with transient hypohidrosis induced by topiramate.
OBJECTIVE
Hypohidrosis, often associated with hyperthermia, has been reported, mostly in children, as a rare and reversible adverse effect of topiramate, an anticonvulsant drug with a broad spectrum of antiepileptic activity. The aim of our study is to detect a possible skin innervation involvement as the mechanism underlying hypohidrosis in children treated with topiramate.


METHODS
A neurophysiological study has been performed on 2 children who have developed hypohidrosis under topiramate treatment. Electrophysiological data have been recorded during topiramate treatment and compared with a control group. Sympathetic skin responses have been recorded during topiramate assumption and after its discontinuation.


RESULTS
In our 2 cases with hypohidrosis related to topiramate, electrophysiological study showed normal function of both beta and delta sensory fibers and absent sympathetic skin responses that recovered to normal after topiramate discontinuation.


CONCLUSIONS
Our findings confirm that topiramate might induce a transitory specific carbonic anhydrase block at the level of sweat glands, without involvement of peripheral nervous system.
Margari
Lucia
L
Child Neurological and Psychiatric Service, Department of Neurological and Psychiatric Sciences, University of Bari, Bari, Italy. l.margari@neurol.uniba.it
Ventura
Patrizia
P
Buttiglione
Maura
M
Presicci
Anna
A
Lucarelli
Elisabetta
E
Sardaro
Michele
M
Di Fruscolo
Olimpia
O
de Tommaso
Marina
M
D000200:Action Potentials / Q000187:drug effects / Q000502:physiology; D000927:Anticonvulsants / Q000009:adverse effects*; D002648:Child; D055724:Electrophysiological Phenomena / Q000187:drug effects* / Q000502:physiology; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D006801:Humans; D007007:Hypohidrosis / Q000139:chemically induced* / Q000503:physiopathology; D008297:Male; D009431:Neural Conduction / Q000187:drug effects / Q000502:physiology; D012867:Skin / Q000187:drug effects / Q000294:innervation; D012879:Skin Physiological Phenomena / Q000187:drug effects; D013497:Sural Nerve / Q000187:drug effects / Q000503:physiopathology; D013546:Sweating / Q000187:drug effects / Q000502:physiology; D013564:Sympathetic Nervous System / Q000187:drug effects; D000077236:Topiramate; D014459:Ulnar Nerve / Q000187:drug effects / Q000503:physiopathology
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose