Reply: Vascular hemichorea/hemiballism and topiramate

✍ Scribed by Emilia Mabel Gatto; Claudia Uribe Roca; Gabriela Raina; Marcelo Gorja; Silvia Folgar; Federico E. Micheli

• Book ID: 102500930
• Publisher: John Wiley and Sons
• Year: 2006
• Tongue: English
• Weight: 36 KB
• Volume: 21
• Category: Article
• ISSN: 0885-3185
• DOI: 10.1002/mds.20783

✦ Synopsis

We appreciate and agree with the comments by Dr. Zesiewicz and colleagues supporting our view that TPM may offer an alternative to the use of neuroleptics in treating HC/HB.

Their case is very similar to ours and a remarkable response was achieved with low doses of topiramate. However, some cases of HC/HB are self-limited and we feel it should have been useful to withdraw topiramate as we did in our case, to prove that the improvement was due to the drug and not to the regressive course of the disorder.

It is important to highlight that a good responses can be achieved using low doses of TPM, 1 which in turn reduces the chance of causing the well-known side effects induced by TPM, including cognitive impairment.

The present case report and others show that TPM might enhance indirectly the GABAergic transmission in the basal ganglia. More extensive and controlled studies on TPM in movement disorders are warranted to determine the role of this drug in the treatment of such disorders.