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Topiramate and visual loss in a patient carrying a Leber hereditary optic neuropathy mutation
Steno Rinalduzzi1, Anna Maria Cipriani, Neri Accornero
1UOC Neurology and Neurophysiopathology, Ospedale Sandro Pertini, Via Monti Tiburtini 385, 00157 Rome, Italy. r.steno@libero.it
Abstract:
We describe a 43-year-old patient who experienced visual loss 4 years after beginning antiepileptic therapy with topiramate. Ophthalmological and neurological examinations led to a preliminary diagnosis of bilateral toxic optic neuritis. Mitochondrial genome sequence analysis detected a Leber hereditary optic neuropathy 11778G>A mutation. The possibility that topiramate might favor a conversion disease, alerts physicians to seek a history of blindness in patients undergoing chronic antiepileptic therapy.
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