title: Successful treatment of cerebellar ataxia and tremor in multiple sclerosis with topiramate: a case report.
abstract: We describe the clinical efficacy of topiramate for treatment of cerebellar dysfunction in a 33-year-old female patient with relapsing remitting multiple sclerosis. The patient presented severe ataxia and tremor precluding many activities of daily life. Topiramate was administered as a monotherapy and slowly tapered in to 150 mg daily without negative side effects. Treatment was well tolerated and led to a marked and lasting improvement of tremor as well as ataxia during an observation period of 2 years. Upon transient withdrawal of topiramate, ataxia and tremor worsened but were again improved after re-dosing of the drug. Multiple sclerosis immunotherapy was not changed in this period. In conclusion, topiramate may be a new therapeutic option to treat cerebellar tremor and ataxia in patients with multiple sclerosis.
authors.affiliation: Department of Neurology, St. Josef Hospital, Ruhr-University Bochum, Bochum, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Schroeder
authors.forename: Ralf A
authors.initials: RA
authors.lastname: Linker
authors.forename: Carsten
authors.initials: C
authors.lastname: Lukas
authors.forename: Peter H
authors.initials: PH
authors.lastname: Kraus
authors.forename: Ralf
authors.initials: R
authors.lastname: Gold
mesh_terms: D000328:Adult; D018726:Anti-Dyskinesia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use; D002524:Cerebellar Ataxia / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005632:Fructose / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006801:Humans; D020529:Multiple Sclerosis, Relapsing-Remitting / Q000188:drug therapy* / Q000503:physiopathology*; D056687:Off-Label Use; D000077236:Topiramate; D016896:Treatment Outcome; D014202:Tremor / Q000188:drug therapy* / Q000209:etiology
chemical_list: D018726:Anti-Dyskinesia Agents; D000927:Anticonvulsants; D000077236:Topiramate; D005632:Fructose