HEAT STROKE-LIKE EPISODE IN A CHILD CAUSED BY ZONISAMIDE

A 2-year-old mentally retarded boy with frontal lobe epilepsy presente d with an episode that resembled heat stroke during the administration of zonisamide. He developed hyperpyrexia with oligohidrosis and centr al neurological symptoms, including, chorea-like involuntary movements , resting tremor, and cogwheel rigidity. A sweat test using pilocarpin e iontophoresis revealed a marked reduction in the sweat response, whi ch suggested a postganglionic sweating dysfunction. A skin biopsy exam ined by light and electron microscopy showed no morphological abnormal ity in the sweat glands. The oligohidrosis caused by zonisamide was re versible in that the patient regained the ability to sweat within 2 we eks of the cessation of drug administration. Children receiving zonisa mide should be monitored for oligohidrosis and the development of neur ological symptoms associated with an elevation of body temperature, (C ) 1997 Elsevier Science B.V.