Around 20% of neurologists in the America were not aware of antiepileptic safety risks in patients of Asian descent. Carbamazepine (CBZ) remaining the first line therapy for trigeminal neuralgia, is causative for ADRs ranging from mild maculopapular exanthema to life threatening severe reactions, including SJS, an immune complex mediated hypersensitivity reaction that involving mucous membranes and the skin. At extreme ages, due to decreased immunity Stevens-Johnson syndrome is reported mostly. Patients with viral infections seem to have a higher risk of acquiring Stevens-Johnson syndrome. Antiepileptics, antibiotics and anticonvulsants are mostly reported to be implicated in Stevens-Johnson syndrome. Drugs with longer half-life were reported to cause adverse reactions more than those of with shorter half-life. Enzymes responsible for bioactivation and detoxification of Carbamazepine and their potential defects were proposed as possible mechanism for Stevens-Johnson syndrome. Fluid and electrolyte imbalances, moderate leukocytosis, elevated liver transaminase, microalbuminuria, hypoproteinuria, hyponatremia, and anaemia are known symptoms of Stevens-Johnson syndrome. ALDENS algorithm is specific method for diagnosis Stevens-Johnson Syndrome. The Food and Drug Administration in the United States, in 2007 recommended genetic testing of HLA-B*1502 allele in patients with ancestry across areas of Asia before prescribing Carbamazepine. Corticosteroids and intravenous immunoglobulins are immediate treatment options of Steven-Johnson syndrome. In United States, the average annual incidence of SJS was estimated to be around 1.2 to 6 cases per million with a male to female ratio of 1.5:1.
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