A case of fever following antiepileptic treatment

A 23-year-old female patient treated with 900 mg oxcarbazepine for complex partial seizures is presented. Good seizure control and slight fever were noted a few weeks after drug administration. Reduction of oxcarbazepine and replacement with valproate resulted in a transient normothermia. Because of fever reappearance, vigabatrin was added and valproate was gradually reduced. Seizures reappeared, but the body temperature fell below 37∘C. Substitution of valproate for lamotrigine resulted in seizure control but abnormal body temperature (37– 37.6∘C) was noted again. Repeated hospital admission for clinical and laboratory investigation before any change of treatment revealed no other abnormal findings. The patient’s abnormal temperature possibly reflects a derangement of high-level temperature control.