Cerebellar Cognitive Affective Syndrome Associated With Topiramate

Clin Neurol Neurosurg. 2008 May;110(5):496-9. doi: 10.1016/j.clineuro.2008.01.003. Epub 2008 Mar 4.

Abstract

The cerebellar cognitive affective syndrome (CCAS) represents a spectrum of cerebellar-induced neurocognitive and affective disturbances. In this report a patient is described who developed CCAS under a treatment with standard daily dose of the anti-epileptic drug topiramate (TPM). Cognitive disturbances consisted of impaired visuo-spatial memory, concentration deficits and executive dysfunctions. Behavior and affect were characterized by marked mood-swings and several disinhibited symptoms. After a gradual discontinuation of treatment with topiramate, a complete remission of the cognitive and affective symptoms was observed within 6 weeks. Functional neuroimaging studies by means of SPECT were conducted 2 weeks and 8 months following TPM discontinuation. This case report seems to suggest that functional disruption of the cerebello-cerebral circuitry, leading to CCAS, can follow treatment with topiramate.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Amines / administration & dosage
  • Anticonvulsants / administration & dosage
  • Anticonvulsants / adverse effects*
  • Carbamazepine / administration & dosage
  • Carbamazepine / analogs & derivatives
  • Cerebellar Diseases / chemically induced*
  • Cerebellar Diseases / complications
  • Cerebellum / drug effects
  • Cognition Disorders / chemically induced*
  • Cognition Disorders / complications
  • Cyclohexanecarboxylic Acids / administration & dosage
  • Drug Therapy, Combination
  • Epilepsy / complications
  • Epilepsy / drug therapy
  • Female
  • Follow-Up Studies
  • Fructose / administration & dosage
  • Fructose / adverse effects
  • Fructose / analogs & derivatives*
  • Gabapentin
  • Humans
  • Middle Aged
  • Mood Disorders / chemically induced*
  • Mood Disorders / complications
  • Neuropsychological Tests
  • Oxcarbazepine
  • Syndrome
  • Topiramate
  • Treatment Outcome
  • gamma-Aminobutyric Acid / administration & dosage

Substances

  • Amines
  • Anticonvulsants
  • Cyclohexanecarboxylic Acids
  • Topiramate
  • Fructose
  • Carbamazepine
  • gamma-Aminobutyric Acid
  • Gabapentin
  • Oxcarbazepine