Clobazam, a 1-5 benzodiazepine, was introduced
in the 1970s for the treatment of anxiety and agitation. Antiepileptic
properties were recognized, and efficacy in a number of epilepsy syndromes was
demonstrated in humans, with good tolerance. Recent reviews are generally favorable,
with a relative minimum of medication-related side effects. However, a number
of benzodiazepines have been associated with causing hypothermia. To date, this
side effect has not been reported with clobazam. We report two cases of
profound hypothermia associated with the use of this medication for the
treatment of epilepsy. Both children had significant cerebral dysgenesis and
were developmentally impaired, but neither had experienced hypothermia before.
Temperature dysregulation was resolved with medication withdrawal after an
extensive work-up for alternative causes. Hypothermia should
be considered as a possible side effect of clobazam, although the exact
mechanism is unknown. Appropriate monitoring of temperature is appropriate, and
precautions should be offered by caregivers.
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