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

Cerebellar cognitive affective syndrome associated with topiramate.

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Department of Linguistics, Vrije Universiteit Brussel, Brussels, Belgium.


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.

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