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J Neurol Neurosurg Psychiatry 63:549-550 doi:10.1136/jnnp.63.4.549
  • Letters to the editor

Alopecia with carbamazepine in two patients with focal seizures

  1. AKIO IKEDA,
  2. HIROSHI SHIBASAKI
  1. Department of Brain Pathophysiology
  2. Department of Neurology, Kyoto University School of Medicine, Shogoin, Sakyo-ku, Kyoto, 606, Japan
  1. Dr Akio Ikeda, Department of Brain Pathophysiology, Kyoto University School of Medicine, Shogoin, Sakyo-ku, Kyoto, 606, Japan.
  1. AIKO SHIOZAKI,
  2. JUN KIMURA
  1. Department of Brain Pathophysiology
  2. Department of Neurology, Kyoto University School of Medicine, Shogoin, Sakyo-ku, Kyoto, 606, Japan
  1. Dr Akio Ikeda, Department of Brain Pathophysiology, Kyoto University School of Medicine, Shogoin, Sakyo-ku, Kyoto, 606, Japan.

    In the treatment of patients with epilepsy with antiepileptic drugs, alopecia was reported in association with valproic acid (VPA),1 and on rare occasions with carbamazepine (CBZ).2 3 We recently encountered two young women with partial seizures who developed alopecia after starting CBZ.

    Patient 1 was a 32 year old woman with a diagnosis of left frontal lobe epilepsy since the age of 27. Her habitual seizures were simple partial seizures consisting of tonic contraction of her right hand and bilateral orbicularis oculi muscles, followed by eye deviation to the right and clonic convulsion of the right side of her face, which were not usually associated with disturbance of consciousness. A cranial MRI was normal and routine EEG showed normal background activity and intermittent irregular 2-3 Hz slow activity at the left frontotemporal area seen every 50 to 100 seconds. As the seizures had started occurring often, the patient had been started on VPA (1200 mg/day) and diazepam (6 mg/day). Because alopecia developed over a period of several months, these two drugs were discontinued, and then the hair loss stopped. As her seizures became less frequent despite discontinuing VPA and diazepam, no medication had been taken in the next year until she visited …