Carbamazepine-Induced Paroxysmal Dysarthria and Ataxia in an Elderly Patient: A Case Report and Clinical Considerations

To report a case of carbamazepine-induced neurotoxicity presenting as paroxysmal dysarthria with ataxia, and to highlight clinical risk factors and diagnostic challenges. This case mimicked a transient ischemic attack (TIA), representing a significant diagnostic pitfall. We present the case of a 71-year-old woman who developed acute paroxysmal dysarthria and ataxia after initiating carbamazepine for otoneuralgia....

No actionable change for audiologists; this neurotoxicity case report is primarily relevant to neurologists and prescribing physicians, though audiologists monitoring patients on carbamazepine should be aware that balance and speech symptoms may signal drug toxicity rather than new hearing or vestibular pathology.

Carbamazepine neurotoxicity is underrecognized in elderly patients and can mimic neurological or vestibular disorders, highlighting the need for careful medication review when unexplained balance or speech symptoms arise.

1. 01Single elderly patient developed paroxysmal (sudden, episodic) dysarthria and ataxia attributed to carbamazepine toxicity.
2. 02Neurotoxic side effects of carbamazepine can mimic primary neurological or vestibular disorders.
3. 03Elderly patients are at higher risk due to altered drug metabolism.
4. 04Audiologists should flag balance/speech symptoms in patients on carbamazepine for physician review.
5. 05Published in Neurotoxicity Research (DOI: 10.1007/s12640-026-00803-4).

PMID

42319725

DOI

10.1007/s12640-026-00803-4.

Journal

Neurotoxicity Research

Publication type

case_report

Evidence level

4

Sample size

1

Population

Single elderly patient on carbamazepine therapy

Intervention

Carbamazepine (antiepileptic/analgesic medication)