Reversible nonfluent aphasia and left frontal hypoperfusion during topiramate treatment.
We report the case of a patient with complex partial seizures who developed a nonfluent aphasia when topiramate was added to his therapy. This emergent adverse effect appeared to be reversible, as language performance improved after discontinuation of topiramate. Interictal SPECT performed when the patient was aphasic revealed a focal perfusion reduction in the left lateral and mesial frontal cortex, which was no longer evident at a follow-up study after language recovery.
Cappa
S F
SF
Department of Neuroscience, Vita-Salute University and San Raffaele Scientific Institute, Milan, Italy. cappa.stefano@hsr.it
Ortelli
P
P
Garibotto
V
V
Zamboni
M
M
D000927:Anticonvulsants / Q000009:adverse effects*; D001039:Aphasia, Broca / Q000139:chemically induced* / Q000000981:diagnostic imaging / Q000473:pathology; D001931:Brain Mapping; D002560:Cerebrovascular Circulation / Q000502:physiology*; D004828:Epilepsies, Partial / Q000000981:diagnostic imaging / Q000188:drug therapy; D005625:Frontal Lobe / Q000503:physiopathology*; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives*; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D015899:Tomography, Emission-Computed, Single-Photon / Q000379:methods; D000077236:Topiramate
D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose