Lamotrigine-Associated Progressive Dysphasia and Cognitive Dysfunction

Lamotrigine is generally accepted as a well-tolerated medication with few cognitive side effects. Here, we report a case of a 62-year old female with a severe, rapidly progressive dementia-like process which was completely reversed after reduction of lamotrigine. Associated findings included hyperreflexia with clonus, ataxia, Wernicke-like aphasia, global cognitive impairment, burst suppression on electroencephalogram (EEG), and bilateral parietal hypo-metabolism on fluorodeoxyglucose-Positron Emission Tomography (FDG-PET). To our knowledge, this is the first case of a severe neuropsychiatric syndrome attributed to lamotrigine at the Food and Drug administration (FDA) recommended dose and not associated with epileptic activity.