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Age, dose, and environmental temperature are risk factors for topiramate-related hyperthermia

To determine the risk of occurrence of hyperthermia during topiramate therapy,1–4 and the risk factors of developing hyperthermia, we investigated all patients (predominantly Lebanese Arabs) seen in our epilepsy clinic during a 2-year period.

Inclusion criteria were diagnosis of epilepsy treated with at least one antiepileptic drug (AED) and patient or family able to accurately report side effects.

Exclusion criteria were 1) medical condition or drugs that could cause or mask the occurrence of fever, 2) clinical findings that indicate another cause of hyperthermia, or 3) any episodes of hyperthermia that were not properly evaluated.

Detailed clinical information was gathered on each patient at baseline and every 3 to 4 months during a 2-year prospective follow-up. Patients or family members were systematically asked about adverse experiences, but hyperthermia was not specifically mentioned to avoid bias. If hyperthermia was reported, then detailed clinical and laboratory data were collected. Hyperthermia was defined as …