Exacerbation of focal seizures due to carbamazepine treatment in an adult patient.

Exacerbation of seizures by carbamazepine (CBZ) has been well documented in children. These were mainly generalized convulsions and only rarely was an increase in previous focal convulsions observed. We report an adult epileptic patient, who had an increased frequency of focal seizures following treatment with CBZ. The exacerbation occurred with high CBZ blood levels, but there were no other signs of encephalopathy. Lowering the dose of CBZ was followed by dramatic clinical improvement. This report points to the possibility that increased focal seizure frequency under CBZ treatment in adults may imply drug effect, rather than worsening of the underlying disease.