Topiramate, Pseudotumor Cerebri, Weight-Loss and Glaucoma: An Ophthalmologic Perspective

Alore, Patrick L.; Jay, Walter M.; Macken, Mícheál P.

doi:10.1080/08820530500509325

Cited by 23 publications

(7 citation statements)

References 19 publications

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“…Rare cases of acute angle-closure glaucoma and myopia were reported. 80 – 82 As topiramate is a prophylactic medication for other forms of headache including migraine, it may be particularly effective in IIH patients without papilledema or in IIH patients with migraine who have intractable headache after resolution of papilledema. 83 …”

Section: Current Managementmentioning

confidence: 99%

Idiopathic intracranial hypertension: ongoing clinical challenges and future prospects

Julayanont¹,

Ruthirago²,

Panikkath³

et al. 2016

JPR

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Idiopathic intracranial hypertension (IIH) is an uncommon disorder characterized by increased intracranial pressure without radiological or laboratory evidence of intracranial pathology except empty sella turcica, optic nerve sheath with filled out cerebrospinal fluid spaces, and smooth-walled nonflow-related venous sinus stenosis or collapse. This condition typically affects obese women. The incidence of IIH is increasing with the rising prevalence of obesity. Persistent headache is the most common symptom. Visual impairment is a serious complication that may not be recognized by the patients. This paper reviews clinical manifestations, diagnostic challenges, and current treatments of IIH in adults. Various imaging modalities have been studied on their validity for detection of IIH and papilledema. This review also includes new studies on medical, surgical, and interventional management of this condition. Acetazolamide and topiramate are the only two medications that have been studied in randomized controlled trials about their efficacy in treatment of IIH. In patients who have severe visual impairment or progressive visual deterioration despite medical management, surgical or interventional treatment may be considered. The efficacy and complications of cerebrospinal fluid diversion, optic nerve sheath fenestration, and endovascular venous stenting reported in the last 3 decades have been summarized in this review. Finally, the prospective aspects of biomarkers and treatments are proposed for future research.

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Section: Current Managementmentioning

confidence: 99%

Idiopathic intracranial hypertension: ongoing clinical challenges and future prospects

Julayanont¹,

Ruthirago²,

Panikkath³

et al. 2016

JPR

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“…Topiramate has been associated in case reports with various medical conditions, including metabolic acidosis (136)(137)(138)(139), nephrolithiasis (140)(141)(142), and glaucoma (143)(144)(145), while oxcarbazepine has been linked to the induction of the syndrome of inappropriate antidiuretic hormone secretion (SI-ADH) (146).…”

Section: Treatment Of Bipolar Disorder In Patients With Medical Comormentioning

confidence: 99%

Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: update 2007

et al. 2006

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“…Management strategies aim to lower intracranial pressure through one or more of the following: removal of the offending agent (discontinuation of ATRA), removal of CSF (therapeutic LPs), inhibition of CSF production (acetazolamide), diuresis (mannitol, glycerin, furosemide), and analgesia. Topiramate has more recently been described as a treatment option for PTC [28]. This agent is primarily used in the management of epilepsy, but is also indicated for migraine prophylaxis [30].…”

Section: Discussionmentioning

confidence: 99%

High pseudotumor cerebri incidence in tretinoin and arsenic treated acute promyelocytic leukemia and the role of topiramate after acetazolamide failure

Smith

Griffiths

Thompson

et al. 2014

Leukemia Research Reports

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Dual differentiation therapy with arsenic trioxide and tretinoin (all-trans-retinoic acid; ATRA) for the management of low and intermediate risk acute promyelocytic leukemia has recently been recommended by the National Comprehensive Cancer Network. Some less common toxicities of the combination may have yet to be fully realized. Of ten patients we have treated thus far, five (50%) have developed pseudotumor cerebri. In one patient, temporary discontinuation of ATRA and initiation of acetazolamide controlled symptoms. In four patients, topiramate was substituted for acetazolamide to relieve symptoms and allow ATRA dose re-escalation. We conclude that providers should monitor for pseudotumor cerebri and consider topiramate if acetazolamide fails.

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Topiramate, Pseudotumor Cerebri, Weight-Loss and Glaucoma: An Ophthalmologic Perspective

Cited by 23 publications

References 19 publications

Idiopathic intracranial hypertension: ongoing clinical challenges and future prospects

Idiopathic intracranial hypertension: ongoing clinical challenges and future prospects

Canadian Network for Mood and Anxiety Treatments (CANMAT) guidelines for the management of patients with bipolar disorder: update 2007

High pseudotumor cerebri incidence in tretinoin and arsenic treated acute promyelocytic leukemia and the role of topiramate after acetazolamide failure

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