Topiramate-induced palinopsia: A case series and review of the literature

Background: To report palinopsia as a possible side effect of topiramate. Methods: Case series and review of the literature. Results: Nine patients in our series, and 4 previously reported patients, who developed palinopsia while on topiramate, are reviewed. All patients were women, and comorbidities included migraine, idiopathic intracranial hypertension, and bulimia nervosa. Palinopsia resolved in 8 patients after stopping or decreasing the dose of topiramate. The lowest dose of topiramate causing palinopsia was 25 mg twice a day. More than half of our patients reported exacerbation of visual disturbance in early morning or late evening. Conclusions: Topiramate-induced palinopsia may be underdiagnosed because physicians do not inquire about such visual symptoms.