Hypersensitivity to antiepileptic drugs.

Abstract

Adverse reactions to antiepileptic drugs (AEDs) may lead to treatment failure,

morbidity, and mortality. Drug hypersensitivity reactions (DHRs) are potentially

fatal. AED DHRs present with a variety of clinical manifestations. The

pathogenesis of AED DHRs has not been fully elucidated. Bioactivation,

detoxification, covalent adduct formation, presentation to the immune system, and

consequent formation of antibody and T-cell immune effectors have been suggested.

This article summarizes the epidemiology, pathogenic mechanisms, risk factors,

clinical features, and management of allergic reactions to the aromatic AEDs

carbamazepine, phenytoin, and lamotrigine.