Reversible Tremor, Myoclonus, and Fasciculations Associated with Topiramate Use for Migraine

Abstract

Objective: 

To report a patient with tremor, multifocal myoclonus, and fasciculations, possibly induced by the antiepileptic drug topiramate.

Case Report: 

A 46-year-old woman with frequent episodes of migraine without aura that were not controlled with other prophylactic drug, developed a reversible clinical picture of postural tremor, multifocal myoclonus, weight loss, amyotrophia, and fasciculations after exposure to topiramate. These symptoms disappeared after topiramate withdrawal.

Conclusions: 

Tremor, myoclonus, and fasciculations should be considered as a possible adverse effect of topiramate.