Cerminara Caterina, Seri Stefano, Bombardieri Roberta, Pinci Mariangela, Curatolo Paolo
Department of Neuroscience, Pediatric Neurology Unit, Tor Vergata University, Rome, Italy.
Pediatr Neurol. 2006 May;34(5):392-4. doi: 10.1016/j.pediatrneurol.2005.10.004.
Topiramate is an antiepileptic drug with a beneficial clinical effect on various seizure types. Topiramate does not seem to be associated with serious adverse effects and is also well tolerated in pediatric patients. Only few cases of hypohidrosis have been described. This report presents one young patient with complex partial seizures who was medicated with topiramate when she developed fatigue, headache, intermittent hyperthermia, inability to produce sweat secretion, and dryness of the skin. Reduced sweat response was determined using the Wescor Macroduct collection procedure. Topiramate was discontinued, and within 3 weeks a repeat sweat test was completely normal. At that time, clinical signs had also disappeared. Hypohidrosis is an uncommon and reversible side effect reported in association with topiramate therapy. It is rare in patients on monotherapy. Although a definite causal relationship still needs to be established, this side effect might be attributed to an autonomic dysfunction by inhibition of isoenzymes of carbonic anhydrase localized in human eccrine sweat glands.
托吡酯是一种对多种癫痫发作类型均有有益临床效果的抗癫痫药物。托吡酯似乎与严重不良反应无关，在儿科患者中耐受性也良好。仅有少数关于少汗症的病例被描述过。本报告介绍了一名患有复杂部分性发作的年轻患者，在服用托吡酯时出现了疲劳、头痛、间歇性高热、无汗分泌能力以及皮肤干燥的症状。使用Wescor Macroduct收集程序测定了汗液反应降低的情况。停用托吡酯后，3周内重复进行的汗液测试完全正常。此时，临床症状也已消失。少汗症是与托吡酯治疗相关的一种罕见且可逆的副作用。在单药治疗的患者中较为罕见。尽管仍需确定明确的因果关系，但这种副作用可能归因于抑制了人类小汗腺中碳酸酐酶同工酶导致的自主神经功能障碍。
