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Changes in Serum Anticonvulsant Levels with Febrile Illness in Children with Epilepsy

Published online by Cambridge University Press:  18 September 2015

Keith J. Goulden ,
Peter R. Camfield ,
Carol S. Camfield ,
John A.R. Tibbles ,
Joseph M. Dooley ,
Albert D. Fraser  and
Kenneth W. Renton
Keith J. Goulden
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
Peter R. Camfield*
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
Carol S. Camfield
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
John A.R. Tibbles
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
Joseph M. Dooley
Affiliation:
Department of Pediatrics, Dalhousie University and I.W. Killam Hospital for Children, Halifax
Albert D. Fraser
Affiliation:
Department of Pathology, Dalhousie University and Toxicology Laboratory, Victoria General Hospital, Halifax
Kenneth W. Renton
Affiliation:
Department of Pharmacology, Dalhousie University, Halifax
*
I.W.K. Hospital for Children, 5850 University Ave., Halifax, N.S., Canada B3J 3G9
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Abstract:

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Changes in anticonvulsant serum levels during intercurrent illness may cause toxicity or decreased seizure control in children with epilepsy. We studied prospectively the effect of intercurrent illness and its treatment in 111 children being treated with AC monotherapy. Free fraction and total serum AC levels were determined when the child was well, on the fifth day of any illness with fever and one month after recovery. There were 55 episodes of febrile illness in 39 children during the study period. Twelve illnesses were associated with significant increases or decreases in serum AC levels; 7 children became clinically toxic; 1 child had increased seizures during illness. The mechanisms of AC level changes appeared to include interaction with antibiotics, with antipyretics or with viral illness. Amoxycillin and acetaminophen did not appear to interact with the AC's used. Physicians caring for children with epilepsy should be aware of the frequency and complexity of potential interactions between intercurrent febrile illness and anticonvulsant medication.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 15 , Issue 3 , August 1988 , pp. 281 - 285
Copyright
Copyright © Canadian Neurological Sciences Federation 1988

References

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