Scalp allodynia-precipitating seizures in a girl after starting topiramate

Abstract

We are reporting the case of a 9-year-old girl with left sided complex partial epilepsy who developed scalp allodynia after commencing topiramate. She first had seizures at the age of 6 weeks. Apart from having epilepsy, she is generally healthy and making normal educational progress. Her electroencephalographs have shown some bursts of irregular spike wave activity particularly in the right central region. A computerize tomography brain scan and two magnetic resonance imaging brain scans, one performed recently, have been normal. Initially her epilepsy responded to phenobarbitole and she remained seizure free for 3 years after it was stopped. At the age of 5 years, she had a recurrence of seizures. During these episodes, she turned her head to the left and had left leg jerking associated with confusion and at times loss of consciousness. Her seizures were occurring several times a week. Subsequently, she was prescribed various antiepileptic drugs (AEDs) including carbamazepine, sodium valproate and levetiracetam as monotherapies and in combination. Most of the AEDs initially did have a beneficial effect but seizure control wore of quickly. After starting topiramate, levetiracetam dose was gradually reduced and