Ethosuximide induced macroglossia and oropharyngeal edema

Int J Pediatr Otorhinolaryngol. 2021 Jan:140:110498. doi: 10.1016/j.ijporl.2020.110498. Epub 2020 Nov 15.

Abstract

Acute macroglossia and laryngeal edema are rare adverse side effects that can cause life-threatening airway obstruction. We report a case of acute macroglossia that began after initiation of ethosuximide in a 15-year-old female with severe medically refractory epilepsy. Macroglossia worsened over the next two weeks of ethosuximide administration, preventing extubation. Macroglossia and laryngeal edema improved upon ethosuximide wean, and completely resolved after discontinuation. The patient was extubated successfully, with precautionary nasal trumpet placement and dexamethasone administration prior to extubation. In medically complex patients on multiple pharmacologic agents, anti-epileptic drugs should be suspected as a possible cause of acute macroglossia.

Keywords: Antiepileptic drugs; Drug-induced macroglossia; Ethosuximide; Macroglossia.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Airway Extubation
  • Airway Obstruction*
  • Edema / chemically induced
  • Ethosuximide
  • Female
  • Humans
  • Macroglossia* / chemically induced

Substances

  • Ethosuximide