Immune-mediated drug reactions are a potentially life-threatening complication of antiseizure medications. Drug hypersensitivity syndrome (DHS) is the best recognised of these, presenting with fever, eosinophilia, rash and internal organ involvement. Isolated lymphadenopathy is a less recognized immune-mediated reaction to antiseizure drugs such as lamotrigine. We describe the case of a 24-year-old woman who developed lamotrigine-related bilateral cervical lymphadenopathy (pseudolymphoma) fifteen months following therapy initiation. This is the second such case reported in the medical literature. Highlights ? Localised lymphadenopathy, especially cervical, is a potential complication of antiseizure therapy ? Drug-induced pseudolymphoma is a distinct entity from, and occurs without other features of drug hypersensitivity syndrome ? Eosinophilia in a patient with lymphadenopathy should prompt the clinician to consider a diagnosis of a drug reaction ? Discontinuation of the offending drug in cases of medication-induced lymphadenopathy often leads to clinical improvement.
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