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Topiramate and Metabolic Acidosis
Author(s) -
Wilner Andrew,
Raymond Kent,
Pollard Richard
Publication year - 1999
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/j.1528-1157.1999.tb00781.x
Subject(s) - topiramate , metabolic acidosis , carbonic anhydrase inhibitor , medicine , concomitant , carbonic anhydrase , epilepsy , acidosis , antiepileptic drug , anticonvulsant , anesthesia , pharmacology , chemistry , enzyme , psychiatry , biochemistry
Summary: Topiramate (TPM) is a novel antiepileptic medication (AED) with at least three mechanisms of action. A possible fourth mechanism, that of a carbonic anhydrase inhibitor, also may contribute to its antiepileptic properties. We report a patient with intractable epilepsy and normal renal function who developed a normal anion gap metabolic acidosis, which worsened during elective surgery for temporal lobectomy. We believe this side effect of TPM can become clinically significant during surgery, concomitant use of another carbonic anhydrase inhibitor, and potentially with the ketogenic diet.