Sweat glands topiramate

A 9-year-old boy with partial epilepsy taking topiramate 4 mg/kg/day developed hyperthermia, reduced sweating, and tiredness after exercise 4 months after the start of treatment (51). Sudomotor function showed 180 sweat glands/cm (normal 286, fifth percentile 221). After topiramate withdrawal he became asymptomatic and 5 weeks later he had 392 sweat glands/cm. ... 

Sweat glands Hypohidrosis and hyperthermia are uncommon adverse reactions to topiramate and usually occur in children with epilepsy. Reversible hypohidrosis has been reported in an adult taking topiramate for chronic migraine [297 ]. 

Sweat glands The pathogenesis of hypo-hidrosis, a rare and reversible adverse effect of topiramate that is often associated with hyperthermia, has been studied in two children [323" ]. Sympathetic skin responses were recorded during topiramate treatment and after withdrawal. Electrophysiology showed normal function of both beta and delta sensory fibers and absent sympathetic skin responses, which recovered to normal after topiramate withdrawal. The authors concluded that topiramate may cause transient specific inhibition of carbonic anhydrase in sweat glands, without involvement of peripheral nervous system. 

Sweat glands A 32-year-old man on topiramate developed hypohydrosis and subsequent hyperthermia [171 ]. Hypohydrosis is a rare but recognized adverse effect of topiramate that is typically reported in children, possibly due to incomplete development of autonomic mechanisms or changes in surface area as compared to mass or blood volume. Hypohydrosis as a side effect of topiramate has rarely been reported in adults. The mechanism by which topiramate causes hypohydrosis remains unclear. 

Topiramate-associated blue pseudo-chromhidrosis has been described [324 ]. Chromhidrosis is a rare skin disorder, in which the apocrine glands excrete sweat that contains lipofuscin pigments. Pseudo-chromhidrosis is a term used when the eccrine sweat is colored on the surface of the skin as a result of the deposit of extrinsic dyes or paints. Since some carbonic anhydrase isoenzymes are expressed in the sudoral eccrine glands, the hypothesized mechanism of this adverse effect was inhibition of this enzyme by topiramate. 

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