Document Detail


Recovery of cognitive and emotional functioning following withdrawal of topiramate maintenance therapy.
MedLine Citation:
PMID:  11792163     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
I Rorsman; K Källen
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Seizure     Volume:  10     ISSN:  1059-1311     ISO Abbreviation:  Seizure     Publication Date:  2001 Dec 
Date Detail:
Created Date:  2002-01-16     Completed Date:  2002-02-27     Revised Date:  2014-10-21    
Medline Journal Info:
Nlm Unique ID:  9306979     Medline TA:  Seizure     Country:  England    
Other Details:
Languages:  eng     Pagination:  592-5     Citation Subset:  IM    
Copyright Information:
Copyright 2001 BEA Trading Ltd.
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MeSH Terms
Descriptor/Qualifier:
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:
0/Anticonvulsants; 0H73WJJ391/topiramate; 30237-26-4/Fructose

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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