title: Reversal of phrenic nerve palsy with topiramate.
abstract: A 57-year-old Caucasian man presented with diaphragmatic paralysis and type 2 diabetes. He had severe orthopnea that remained unchanged for 1 year. He was later diagnosed with distal symmetric polyneuropathy and was started on topiramate. Within 26 weeks of treatment, the patient showed improvement in diaphragmatic function and regrowth of intraepidermal nerve fibers, accompanied by improvement in respiratory and peripheral neuropathy symptoms. Topiramate may prove to be an effective agent in the treatment of nonremitting diaphragmatic paralysis and regrowth of intraepidermal nerve fibers.
authors.affiliation: Department of Internal Medicine, Strelitz Diabetes Institutes, Eastern Virginia Medical School, Norfolk, VA 23510, USA.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Rice
authors.forename: Jagdeesh
authors.initials: J
authors.lastname: Ullal
authors.forename: Aaron I
authors.initials: AI
authors.lastname: Vinik
mesh_terms: D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology*; D003929:Diabetic Neuropathies / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000503:physiopathology*; D005632:Fructose / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D018696:Neuroprotective Agents / Q000627:therapeutic use*; D010243:Paralysis / Q000188:drug therapy*; D010791:Phrenic Nerve / Q000503:physiopathology*; D013902:Radiography, Thoracic; D000077236:Topiramate; D016896:Treatment Outcome; D014797:Vital Capacity
chemical_list: D018696:Neuroprotective Agents; D000077236:Topiramate; D005632:Fructose