Avascular necrosis of the femoral head, Peripheral nerve damage, Carbamazepine, Case report, Diseases of the musculoskeletal system, RC925-935

Abstract Background Avascular necrosis of the femoral head (ANFH) that is due to the use of carbamazepine (CBZ) in children whose condition requires long-term oral CBZ is relatively rare, and there are no clinical reports on this topic. Herein, we present a rare case of femoral head necrosis and peripheral nerve damage due to long-term use of CBZ in a child with depression. Patient presentation A 12-year-old boy who was taking oral CBZ for depression presented to the hospital with a sudden onset of impaired consciousness. On admission, the blood CBZ concentration was 32.6 µg/mL, an electromyogram (EMG) revealed severe partial injury to the left common peroneal and tibial nerves, and magnetic resonance imaging (MRI) of the hip revealed necrosis of the left femoral head. On predischarge evaluation, the CBZ blood level was