Treatment with carbamazepine (CBZ) in therapeutic levels was associated with motor impairments in 19 children with epilepsy, studied during and 6 months after treatment was withdrawn at Huddinge University Hospital, Sweden. On a Bruininks-Oseretsky standardized test of gross and fine-motor proficiency, the drug-free evaluation showed significant improvements in response speed, fine-motor function, and total test battery scores. In another group of 12 children tested during treatment with CBZ, visual-motor control was impaired on the second test at a 6 month interval. 
COMMENT. Fine motor coordination impairments in children with epilepsy treated with carbamazepine may be explained by effects of the antiepileptic drug.
Cerebellar adverse effects of carbamazepine are reported in 9 (35%) of 26 young adults with chronic focal epilepsy treated at the Klinik Mara 1, Epilepsie-Zentrum Bethel, Bielefeld, Germany . Serum concentrations of CBZ at onset of ataxic side-effects were related to occurrence of cerebellar atrophy on MRI. Patients showing cerebellar atrophy developed ataxia, nystagmus, and dizziness at lower CBZ levels than those without cerebellar atrophy.