Tag Archives: Topamax

Chronic Illness: Current Therapies

The main goal of bipolar disorder drug treatment is to establish euthymia (stable mood with a persistent sense of well-being) without inducing mania or rapid cycling (i.e., four or more mood episodes in a 12-month period). For this reason, drug treatment usually consists of an agent or, more frequently, combinations of agents that exert both… Read More »

Treatment Of The Child Or Adolescent With Newly Diagnosed Epilepsy

Paediatric epilepsy is amazingly diverse. In some children, basic diagnosis, seizure classification and treatment are straightforward. Other patients have difficult-to-diagnose seizures, complicated seizure classification and a variable response to treatment. Some seizures are subclinical, others are barely noticeable, and occasionally they are life threatening. Many children with epilepsy have no associated disabilities, but all children… Read More »

TTHs occurring about once to twice a week…

At a new-patient appointment, a 29-year-old woman reported TTHs occurring about once to twice a week. She had multiple repetitive questions about her headaches and, despite normal brain imaging in the past year, was difficult to reassure that her headaches were not due to a dread disease. At your suggestion, she considered a preventative medication;… Read More »

Treatment of idiopathic intracranial hypertension?

Which of the following is used to preserve vision in patients with idiopathic intracranial hypertension (IIH)? A. Optic nerve sheath decompression (ONSD) B. Intracranial venous sinus stent placement C. Ventriculoperitoneal shunt placement D. Lumboperitoneal shunt placement E. All of the above The answer is E. Optic nerve sheath decompression (ONSD), which is also called optic… Read More »

Which of the drugs has been shown to be effective in the prophylaxis of migraine in children?

Which of the following medications has been shown to be effective in the prophylaxis of basilar-type migraine in children? A. Propranolol (Inderal) B. Topiramate (Topamax) C. Gabapentin (Neurontin) D. Lamotrigine (Lamictal) E. All of the above The answer is B. Basilar-type migraine represents up to 20% of migraine headaches in children and adolescents. This primary… Read More »

Which drug has shown benefit in treating SUNCT?

Which medication has shown benefit in treating SUNCT and short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA)? A. Lamotrigine (Lamictal) B. Gabapentin (Neurontin) C. Topiramate (Topamax) D. Lidocaine E. All of the above The answer is E. SUNCT and SUNA are primary headache syndromes, classified as TACs, and associated with hypothalamic activation. They… Read More »

Which drug is associated with ciliochoroidal detachment?

Which medication is associated with ciliochoroidal detachment? A. Gabapentin (Neurontin) B. Topiramate (Topamax) C. Divalproex sodium (Depakote) D. Carbamazepine (Tegretol) E. Vigabatrin (Sabril) The answer is B. Topiramate (Topamax) may cause idiosyncratic ciliochoroidal detachment and ciliary body edema, leading to anterior displacement of the lensiris diaphragm, lens thickening, and acute angle-closure glaucoma and acute myopia.… Read More »

Which of the drugs appears to be the most effective preventative drug for children and adolescents with headaches?

Which of the following appears to be the most effective preventative medication for children and adolescents with migraine headaches? A. Propranolol (Inderal) B. Gabapentin (Neurontin) C. Topiramate (Topamax) D. Levetiracetam (Keppra) E. Zonisamide (Zonegran) The answer is C. Data on preventative medication for children and adolescents with migraine headaches is sparse, as noted by the… Read More »

Which of these side effects of topiramate (Topamax) primarily involves children?

Which of these side effects of topiramate (Topamax) primarily involves children? A. Word-finding difficulty B. Renal stones C. Paresthesias D. Oligohidrosis E. Acute myopia The answer is D. All of the listed side effects are noted with topiramate (Topamax), with paresthesias being the most common side effect noted in adult patients. Oligohidrosis (decreased sweating) and… Read More »

What is therapeutic gain?

What is therapeutic gain? A. The improvement in quality of living gained by headache relief. B. The percentage response for active treatment minus the percentage response for placebo. C. The minimum response that can be reliably expected from treatment. D. The percentage response with active treatment. E. The consistent improvement seen each time treatment is… Read More »