title: Topiramate-induced severe heatstroke in an adult patient: a case report.
abstract: BACKGROUND
  Heatstroke is a life-threatening condition defined by failure of heat load dissipation, resulting in a core temperature higher than 40 °C (104 °F) associated with neurological dysfunction. Topiramate may cause anhidrosis, potentially resulting in heatstroke, as reported especially in children.
  
  
  METHODS
  A 57-year-old Caucasian man was admitted to the emergency room in a febrile comatose state. After a complete workup ruling out the usual etiologies of such a condition, we assumed the hypothesis of a heatstroke caused by topiramate, recently prescribed for essential tremor.
  
  
  CONCLUSIONS
  Topiramate-related heatstroke has been described in children but must be recognized in adults as well. Outcomes may range from total clinical recovery to persistent neurological dysfunction or death. The prescription of topiramate and the follow-up of adult patients under this medication should include an evaluation of hypohidrosis, especially in contexts of high temperature.
authors.affiliation: Department of Internal Medicine, HUG Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland. lucie.canel@hcuge.ch.
authors.forename: Lucie
authors.initials: L
authors.lastname: Canel
authors.affiliation: Department of Community Medicine, HUG Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Sofia
authors.initials: S
authors.lastname: Zisimopoulou
authors.affiliation: Department of Clinical Pharmacology and Toxicology, HUG Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Marie
authors.initials: M
authors.lastname: Besson
authors.affiliation: Department of Internal Medicine, HUG Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1205, Geneva, Switzerland.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Nendaz
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects*; D020329:Essential Tremor / Q000188:drug therapy*; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D018883:Heat Stroke / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000077236:Topiramate
chemical_list: D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose
keywords: Adult; Anhidrosis; Febrile coma; Heatstroke; Topiramate