Epilepsy is defined as recurrent seizures provoked by any immediate unidentifiable cause. Drug therapy is the mainstay of treatment for patients with epilepsy. Phenytoin, sodium valproate, carbamazepine and ethosuximide are generally used as first line therapy for most seizure disorders. Carbamazepine is one of the most widely used medications for the treatment of partial-onset seizures. Sodium valproate is a broad-spectrum antiepileptic that has proven efficacy against all seizure types, which makes it a useful antiepileptic when exact seizure classification is unknown or multiple seizure type exists. The patients who do not respond to first line antiepileptics or develop side effects to them are invariably prescribed alternative drugs. Clobazam, a long acting benzodiazepine, is one such drug that is given as an adjunctive therapy in these patients.
The aromatic antiepileptics viz. phenytoin, carbamazepine, phenobarbitone and primidone can cause hypersensitivity reactions. For example, carbamazepine can cause pruritic and erythematous rashes, urticaria, photosensitivity reactions, exfoliative dermatitis, alopecia, diaphoresis, erythema multiforme, Stevens-Johnson syndrome and Toxic epidermo necrolysis. In such a case carbamazepine is discontinued and nonaromatic antiepileptics like sodium valproate or a benzodiazepine is usually recommended as an alternative therapy. Here, we present a case in which there was development of acute hypersensitivity reaction to both aromatic and nonaromatic antiepileptics - a rarely reported phenomenon.