Case Reports : Topiramate, a concealed cause of severe metabolic acidosis
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Severe metabolic acidosis is common among critically ill patients, and topiramate is a rare cause that may fail recognition. We report a lady with acute encephalopathy who had severe non-anion gap metabolic acidosis that served as the clue leading to suspicion and diagnosis of topiramate toxicity and was confirmed by elevated blood topiramate levels. Additionally, we provide a review of literature on all reported cases of topiramate toxicity. Keywords: Topiramate, metabolic acidosis, migraine, altered mental status, carbonic anhydrase.
Am J Hosp Med 2017 Jul;1(3):2017.024 https://doi.org/10.24150/ajhm/2017.024