| Recovery of cognitive and emotional functioning following withdrawal of topiramate maintenance therapy. | |
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MedLine Citation:
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PMID: 11792163 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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The present investigation reports cognitive improvement following withdrawal of topiramate (TPM) maintenance therapy in two patients with intractable seizures. The first patient received a neuropsychological evaluation after 10 months of adjunctive TPM treatment and was reassessed after complete withdrawal. The second patient received a first evaluation without TPM therapy. A reassessment was conducted after 13 weeks of stable TPM add-on therapy, and a third evaluation was performed after TPM withdrawal. During TPM treatment, the first patient demonstrated dysfunction on both verbal and non-verbal measures, suggesting bilateral impairment. Reassessment yielded cognitive improvement, and was consistent with a lateralized lesion as supported by seizure semiology, magnetic resonance imaging (MRI), and electroencephalogram (EEG) data. The second patient showed cognitive and emotional declines during TPM therapy. Reassessment, without TPM, demonstrated recovery on a majority of variables. These results illustrate the risk for considerable cognitive side effects after TPM habituation and support good recovery after withdrawal. Attempting to withdraw TPM and conducting a re-evaluation may be especially justified in the presence of a deflated neuropsychological profile that is inconsistent with a patient's estimated level of cognitive functioning. Reducing the influence of medical effects that could mimic bilateral dysfunction is particularly important in presurgical evaluations. |
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Authors:
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I Rorsman; K Källen |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: Seizure : the journal of the British Epilepsy Association Volume: 10 ISSN: 1059-1311 ISO Abbreviation: Seizure Publication Date: 2001 Dec |
Date Detail:
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Created Date: 2002-01-16 Completed Date: 2002-02-27 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 9306979 Medline TA: Seizure Country: England |
Other Details:
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Languages: eng Pagination: 592-5 Citation Subset: IM |
Copyright Information:
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Copyright 2001 BEA Trading Ltd. |
Affiliation:
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Department of Neurology, Lund University Hospital, Sweden. Ia.Rorsman@neurol.lu.se |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anticonvulsants / adverse effects* Cognition / drug effects* Drug Therapy, Combination Emotions / drug effects* Epilepsies, Partial / drug therapy* Female Fructose / adverse effects*, analogs & derivatives* Humans Male Neuropsychological Tests Remission Induction |
| Chemical | |
Reg. No./Substance:
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0/Anticonvulsants; 30237-26-4/Fructose; 97240-79-4/topiramate |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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