We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Images in Neurology |

Topiramate Effect in Opsoclonus-Myoclonus-Ataxia Syndrome

Thiago Dias Fernandes, MD; Rodrigo Bazan, MD; Luiz Eduardo Betting, MD, PhD; Fernando Coronetti Gomes  da Rocha, MD, PhD
Arch Neurol. 2012;69(1):133. doi:10.1001/archneurol.2011.717.
Text Size: A A A
Published online


A 34-year-old woman with no comorbidities developed severe truncal ataxia and opsoclonus progressively over 4 days. The patient was admitted 20 days after onset of symptoms. During hospitalization, she was extensively investigated for the etiology of opsoclonus-myoclonus-ataxia syndrome (OMS). All ancillary tests performed gave normal results, including cerebrospinal fluid examination; serology for infectious diseases and collagenosis; brain and spine magnetic resonance imaging; thoracic, abdominal, and pelvic computerized tomography; and screening for gynecological neoplasias. Topiramate treatment was initiated at a starting dose of 50 mg/d and was titrated up to 150 mg/d over 10 days. During this period, the patient had a remarkable improvement of symptoms (video). After a few days, the topiramate dose was gradually decreased to 50 mg/d. However, after 1 week, ataxia and the opsoclonus clearly worsened. After reestablishing the medication dose to 150 mg/d, symptoms improved again.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

5 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles