Effects of topiramate on dysaesthetic pain in a patient with multiple sclerosis

Dysaesthetic pain is a common neuropathic pain in patients with multiple sclerosis. Both tricyclic antidepressants (i.e., amitriptyline and duloxetine) and antiepileptic drugs (i.e., carbamazepine, gabapentin and pregabalin) represent first-line treatment of neuropathic pain. However, topiramate, an antiepileptic drug, also demonstrated clinical efficacy in these patients. In this report we describe the case of a 42-year-old woman with an 8-year history of multiple sclerosis who developed dysaesthetic pain in the lower limbs, and was successfully treated with topiramate at a final dose of 150 mg/day. About 8 months after beginning topiramate treatment, the patient had not shown any dysaesthetic pain, and no adverse events related to topiramate had been recorded.