[Exacerbation of seizures by carbamazepine in four children with symptomatic localization related epilepsy].

We treated one hundred and seventy-eight epileptic children with carbamazepine (CBZ) for eight years. Among them, four children with symptomatic localization-related epilepsy, aged 11 months to 12 years, developed exacerbation of seizures. Their epilepsies were associated with hypoxic ischemic encephalopathy, head injury and ectopic gray matter. Despite the serum levels of CBZ (7.0 approximately 9.5 micrograms/ml) being within the therapeutic range, all of them had more frequent and severe partial seizures than before taking CBZ and one developed new atonic seizures. Diffuse irregular spike-wave complexes appeared on EEG in two children. Following discontinuation of CBZ in addition to replacement with phenytoin, their seizures became well-controlled and EEG findings improved except for residual focal spikes. Although CBZ is a widely used and effective antiepileptic drug for partial seizures, it should be kept in mind that CBZ may exacerbate seizures in children with symptomatic localization-related epilepsy.