We report a patient who had topiramate use for 4 years to control epilepsy but was repeatedly hospitalized due to frequent seizures since the second year of the treatment,without triggers such as drug withdrawal,drug reduction,irregular treatment,and irregular lifestyles.Intermittent monitoring of ions revealed electrolyte disorders-hyperchlorae-mia,but symptomatic electrolyte correction was always ineffective.After discontinuing topiramate,blood chlorine quickly returned to normal,and epilepsy was successfully controlled.Based on related literature,we further discuss the possible mechanisms of topiramate-induced hyperchloraemia and frequent seizures,aiming to improve the safety of topiramate in clinical application.
TopiramateHyperchloraemiaMechanism of actionEpilepsy