Topiramate-induced Neuropathy Mimicking Carpal Tunnel Syndrome: A Case Report

Document Type : CASE REPORT


1 Rutgers New Jersey Medical School, Newark, NJ

2 Rothman Institute, Division of Hand Surgery, Philadelphia, PA, USA


Carpel tunnel syndrome (CTS) is a condition in which median nerve compression results in paresthesias and pain in the
wrist and hand. We are going to report a rare case of topiramate-induced neuropathy which clinically resembles CTS.
Discontinuation of topiramate resulted in spontaneous resolution of numbness, paresthesia and pain in a few days. High
clinical suspicion is advised in patients who are on topiramate and present with signs of compressive neuropathy.


Main Subjects

1. Atroshi I, Gummesson C, Johnsson R, Ornstein E,
Ranstam J, Rosen I. Prevalence of carpal tunnel
syndrome in a general population. JAMA. 1999;
2. Tuppin P, Blotiere PO, Weill A, Ricordeau P, Allemand
H. [Carpal tunnel syndrome surgery in France in
2008: patients’ characteristics and management]. Rev
Neurol (Paris). 2011; 167(12):905-15.
3. Chammas M, Boretto J, Burmann LM, Ramos RM, Dos
Santos Neto FC, Silva JB. Carpal tunnel syndrome -
Part I (anatomy, physiology, etiology and diagnosis).
Rev Bras Ortop. 2014; 49(5):429-36.
4. Emara MK, Saadah AM. The carpal tunnel syndrome
in hypertensive patients treated with beta-blockers.
Postgrad Med J. 1988; 64(749):191-2.
5. Sestak I, Sapunar F, Cuzick J. Aromatase inhibitorinduced
carpal tunnel syndrome: results from the
ATAC trial. J Clin Oncol. 2009; 27(30):4961-5.
6. Dellon AL, Swier P, Maloney CT Jr, Livengood MS,
Werter S. Chemotherapy-induced neuropathy:
treatment by decompression of peripheral nerves.
Plast Reconstr Surg. 2004; 114(2):478-83.
7. Law HZ, Amirlak B, Cheng J, Sammer DM. An
Association between Carpal Tunnel Syndrome and
Migraine Headaches-National Health Interview
Survey, 2010. Plast Reconstr Surg Glob Open. 2015;
8. Concannon MJ, Gainor B, Petroski GF, Puckett CL.
The predictive value of electrodiagnostic studies in
carpal tunnel syndrome. Plast Reconstr Surg. 1997;
9. Pulman J, Jette N, Dykeman J, Hemming K, Hutton JL,
Marson AG. Topiramate add-on for drug-resistant
partial epilepsy. Cochrane Database Syst Rev. 2014;
10. Lainez MJ, Freitag FG, Pfeil J, Ascher S, Olson WH,
Schwalen S. Time course of adverse events most
commonly associated with topiramate for migraine
prevention. Eur J Neurol. 2007; 14(8):900-6.
11. Privitera MD, Brodie MJ, Mattson RH, Chadwick DW,
Neto W, Wang S, et al. Topiramate, carbamazepine and
valproate monotherapy: double-blind comparison in
newly diagnosed epilepsy. Acta Neurol Scand. 2003;
12. Young WB, Hopkins MM, Shechter AL, Silberstein
SD. Topiramate: a case series study in migraine
prophylaxis. Cephalalgia. 2002; 22(8):659-63.
13. Bray GA, Hollander P, Klein S, Kushner R, Levy B,
Fitchet M, et al. A 6-month randomized, placebocontrolled,
dose-ranging trial of topiramate for weight
loss in obesity. Obes Res. 2003; 11(6):722-33.
14. Majkowski J, Neto W, Wapenaar R, Van Oene J. Time
course of adverse events in patients with localizationrelated
epilepsy receiving topiramate added to
carbamazepine. Epilepsia. 2005; 46(5):648-53.