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topiramate in migraine

Ankur Sinha, Phone Oo, Muhammad U Asghar, Hira A Cheema, Sanwal S Mehta, Joshua C Leinwand, Kalyana Janga
Topiramate (TMP) is a broad-spectrum anticonvulsant drug used to treat a wide variety of seizure disorders, for migraine prophylaxis, and for many other indications. An important side effect of TMP is metabolic acidosis, which is mediated by renal tubular defects. TMP inhibits carbonic anhydrase, an enzyme that is necessary for acid handling in the proximal renal tubule. Patients can present with asymptomatic serum electrolyte derangements, acute change in mental status, hyperventilation, cardiac arrhythmias, or other sequelae of metabolic acidosis and associated respiratory compensation...
November 26, 2018: Curēus
Pi-Chuan Fan, Ping-Hung Kuo, Ming Tatt Lee, Shu-Hui Chang, Lih-Chu Chiou
Background: Plasma calcitonin gene-related peptide (CGRP) plays a key role in the migraine pathophysiology. This study aimed to investigate its role in predicting diagnosis and outcome of pharmacotherapy in pediatric migraine. Methods: We prospectively recruited 120 subjects, who never took migraine-preventive agents in a pediatric clinic, including 68 patients with migraine, 30 with non-migraine headache (NM), and 22 non-headache (NH) age-matched controls. Short-term therapeutic response was measured for at least 2 weeks after the start of therapy...
2019: Frontiers in Neurology
Karen A Williams, Robin M Lawson, Osvaldo H Perurena, John D Coppin
Introduction: The rate of chronic migraine (CM) has been shown to be 20% or greater in the post 9/11 combat veteran population with a history of traumatic brain injury, while the rate is much lower at 3-5% in the general population. Studies have shown that medications such as oral topiramate or intramuscular injections of onabotulinum toxin A (Botox) have been used for CM prevention, and occipital blocks have been shown to be helpful in treating occipital neuralgia and short-term relief of CM...
January 23, 2019: Military Medicine
Wei-Hsi Chen, Yi-Lang Hsu, Yun-Si Chen, Hsin-Ling Yin
OBJECTIVES: In contrast to previous concept that tinnitus is confined to an otologic disorder, current evidence supports it as a phantom sensory phenomenon of vestibulocochlear damage with cortical reorganization. It is a common problem worldwide, but the treatment response is always unsatisfactory. PATIENTS AND METHODS: In this study, we report 10 patients who described their staccato tinnitus as simulating the ticking sound of a pendulum or quartz clock (or termed clocking tinnitus)...
February 2019: Clinical Neurology and Neurosurgery
Hien Ha, Annika Gonzalez
Migraines impose significant health and financial burdens. Approximately 38% of patients with episodic migraines would benefit from preventive therapy, but less than 13% take prophylactic medications. Preventive medication therapy reduces migraine frequency, severity, and headache-related distress. Preventive therapy may also improve quality of life and prevent the progression to chronic migraines. Some indications for preventive therapy include four or more headaches a month, eight or more headache days a month, debilitating headaches, and medication-overuse headaches...
January 1, 2019: American Family Physician
Stefano Manzini, Marco Busnelli, Cinzia Parolini, Lucia Minoli, Alice Ossoli, Elena Brambilla, Sara Simonelli, Eftychia Lekka, Andreas Persidis, Eugenio Scanziani, Giulia Chiesa
Topiramate is an anticonvulsant drug also prescribed for migraine prophylaxis that acts through several mechanisms of action. Several studies indicate that topiramate induces weight loss and a moderate reduction of plasma lipids and glucose. Based on these favourable metabolic effects, aim of this study was to evaluate if topiramate could modulate atherosclerosis development and protect target organs of dysmetabolic conditions. Thirty apoE-deficient mice were divided into three groups and fed for 12 weeks a high fat diet (Control) or the same diet containing topiramate at 0...
December 26, 2018: Pharmacological Research: the Official Journal of the Italian Pharmacological Society
Bilgin Öztürk, Akçay Övünç Özön, Ömer Karadaş
Topiramate for the treatment of migraine prophylaxis may cause side effects such as cognitive dysfunction. We aimed to investigate the topiramate's efficacy in migraineours and effect on cognitive functions. 24 migraine patients (Group 1) and 24 healthy participants (Group 2) were included. In both groups event-related potentials P300 Latency, Amplitude and N200 Latency, Amplitude's were evaluated. Topiramate treatment was ordered to group 1. Two months after treatment, the same parameters were evaluated. Monthly number of attacks, painful days, analgesic-triptan use and VAS scores were compared before and 2 months after treatment...
January 2019: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Pokai Huang, Ping-Hung Kuo, Ming Tatt Lee, Lih-Chu Chiou, Pi-Chuan Fan
Background: Valproic acid (VPA) and topiramate (TPM), initially developed as antiepileptics, are approved for migraine prophylaxis in adults but not children. The differences in their antimigraine mechanism(s) by age remain unclear. Methods: A migraine model induced by intra-cisternal ( i.c. ) capsaicin instillation in pediatric (4-5 weeks) and adult (8-9 weeks) rats was pretreated with VPA (30, 100 mg/kg) or TPM (10, 30, 100 mg/kg). Noxious meningeal stimulation by the irritant capsaicin triggered trigeminovascular system (TGVS) activation mimicking migraine condition, which were assessed peripherally by the depletion of calcitonin gene-related peptide (CGRP) in sensory nerve fibers of the dura mater, the increased CGRP immunoreactivity at trigeminal ganglia (TG) and centrally by the number of c-Fos-immunoreactive (c-Fos-ir) neurons in the trigeminocervical complex (TCC)...
2018: Frontiers in Pharmacology
Clarissa Santos, Donald F Weaver
The topical application of linoleic and linolenic acids is a potential prophylactic approach to migraine via an anti-inflammatory mechanism. We present a 45-year-old woman with chronic migraine without aura. Previous use of abortive or prophylactic therapies including sumatriptan, amitriptyline and topiramate had failed due to lack of efficacy or side-effects, especially vomiting. In search of a topical agent she performed an n-of-1 trial comparing application of linoleic acid (safflower oil) versus oleic acid (olive oil) for migraine relief...
October 10, 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Bu Seon Kang, Jinsun Lee, Jin Hyuk Choi, Hyeok Hee Kwon, Joon Won Kang
PURPOSE: Headache is a common symptom during childhood. It is usually persistent and requires special care. This study aimed to identify the characteristics of headache in children <7 years of age. METHODS: We reviewed 3 years of clinical files on children <7 years of age with a chief complaint of headache. RESULTS: This study included 146 children (66 males, 80 females; mean age, 5.5±1.0 years). Mean symptom duration was 5.8±7.9 months...
November 2018: Korean Journal of Pediatrics
L M Agessi, T R Villa
BACKGROUND:  Approximately 3.9% children with migraine have olfactory hallucination which was defined as a perception of a smell without the substantial existence of any physical odor. CASE:  We described the first two cases of children with vestibular migraine, presenting visual aura and olfactory hallucination. ​ We reported two children with vertigo, visual aura, and olfactory hallucination before the headache who were responsive to topiramate. CONCLUSION:  The clinical description of olfactory hallucination presented some characteristics of migraine aura...
December 2018: Neuropediatrics
Pamela Vo, Shihua Wen, Marie-Josée Martel, Dimos Mitsikostas, Uwe Reuter, Jan Klatt
Objective This study evaluated the benefit-risk profile of erenumab relative to other therapies approved for migraine prophylaxis and available in the majority of European countries. Methods Trials were identified via a published systematic literature review updated to December 2017 using MEDLINE. Erenumab's pivotal trials study reports were also included (NCT02066415, NCT02456740). From these sources, ≥ 50% responder rates and discontinuations due to adverse events were extracted to generate numbers needed to treat and harm and likelihood of being helped or harmed, a quantitative benefit-risk measure...
September 19, 2018: Cephalalgia: An International Journal of Headache
Shin C Beh
Episodic positional vertigo is typically due to benign paroxysmal positional vertigo (BPPV) but may also be a manifestation of vestibular migraine. Distinguishing vestibular migraine from BPPV is essential since the treatment of each disorder is markedly different. The 31-month clinical course of a 41-year-old woman with vestibular migraine causing recurrent positional vertigo is described. During vestibular migraine attacks, she developed left-beating nystagmus in the upright position with removal of fixation, and geotropic horizontal nystagmus during the supine roll test...
July 2018: Headache
Elizabeth Loder, Paul Rizzoli
This paper describes current non-antibody pharmacologic approaches to the prevention of migraine in adults. Preventive therapy should be considered for patients with migraine who routinely have more than 6 headache days per month or in other special circumstances. Choices for preventive therapy are based on patient preferences about side effects and evidence of efficacy. The evidence level and commonly used doses for selected categories of migraine preventive medication are reviewed, including antiepileptic drugs, antihypertensive drugs, and antidepressants...
November 2018: Headache
Welton O'Neal, Elizabeth E Hur, Tesfaye Liranso, Barry Patel
AIM: Examine clinical profile of extended-release topiramate (Trokendi XR® ) and compare treatment-emergent adverse events (TEAEs) associated with Trokendi XR versus previous immediate-release topiramate (TPM-IR) treatment. PATIENTS & METHODS: Pilot retrospective study analyzing data extracted from medical charts of patients ≥6 years of age prescribed Trokendi XR. RESULTS: Trokendi XR was the most commonly used to prevent migraine...
August 23, 2018: Journal of Comparative Effectiveness Research
Padmamalini Mahendradas, Snehanka Parab, Rajesh Sasikumar, Ankush Kawali, Bhujang K Shetty
A 36-year-old female presented with the complaints of pain, photophobia, redness, and sudden diminution of vision in both the eyes following topiramate for migraine treatment. On examination, there was panuveitis with angle-closure glaucoma in both the eyes with fibrinous exudate with pigments in the anterior chamber of the left eye. B scan revealed increased choroidal thickness in both the eyes. Serial anterior segment optical coherence tomography scans were done in the left eye to demonstrate the gradual resolution of the fibrin material from the anterior chamber...
September 2018: Indian Journal of Ophthalmology
Ji-Hyung Park, Kyung-Ah Park, Jihoon Cha, Sung Tae Kim, Chin-Sang Chung, Mi Ji Lee
Background Retinal migraine is an important differential diagnosis of recurrent transient monocular blindness accompanied by headache when other etiologies are excluded. Here, we report a case of orbital vasculitis which initially mimicked retinal migraine. Case report A 47-year-old woman had recurrent episodes of fully reversible transient monocular blindness accompanied by ipsilateral headache for 15 months. The patient's neuroimaging and cardiac and ophthalmologic evaluations were normal. With a diagnosis of retinal migraine, her symptoms remitted in response to prophylactic treatment with topiramate and propranolol for 8 months...
August 12, 2018: Cephalalgia: An International Journal of Headache
Matías Osaba, Víctor Eduardo Reviglio
This work reports on a clinical case of a female who presented with headache, bilateral eye pain and vision loss. Intraocular pressures were 40 mm Hg in the right eye and 45 mm Hg in the left eye. Optical Coherence Tomography examination shows the iridocorneal angle was collapsed and macular striae were also observed. The patient had been on topiramate due to migraines 7 days before presentation. Diagnosis for topiramate-induced acute angle closure was made in both eyes. The patient showed improvement in symptoms a few days after treatment initiation and images confirmed that the iridocorneal angle had been enlarged and macular striae had disappeared...
July 2018: Oxford Medical Case Reports
Clément Verkest, Emilie Piquet, Sylvie Diochot, Mélodie Dauvois, Michel Lanteri-Minet, Eric Lingueglia, Anne Baron
BACKGROUND AND PURPOSE: Acid-sensing ion channels (ASICs) are neuronal proton sensors emerging as potential therapeutic targets in pain of the orofacial region. Amiloride, a non-specific ASIC blocker, has been shown to exert beneficial effects in animal models of migraine and in patients. We explored the involvement of the ASIC1-subtype in cutaneous allodynia, a hallmark of migraine affecting cephalic and extra-cephalic regions in about 70% of migrainers. EXPERIMENTAL APPROACH: We investigated the effects of systemic injections of amiloride and mambalgin-1, a specific inhibitor of ASIC1a- and ASIC1b-containing channels, on cephalic and extra-cephalic mechanical sensitivity in a rodent model of acute and chronic migraine induced by i...
November 2018: British Journal of Pharmacology
Todd J Schwedt
PURPOSE OF REVIEW: This article reviews the preventive therapy of migraine, including indications, strategies for use, and available treatments. RECENT FINDINGS: Lifestyle modifications and migraine trigger avoidance are recommended as preventive measures for all individuals with migraine. The decision to recommend additional migraine preventive therapy should consider the frequency of migraine attacks and headaches, extent of migraine-associated disability, frequency of using acute migraine treatments and the responsiveness to such treatments, and patient preferences...
August 2018: Continuum: Lifelong Learning in Neurology
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