Vascular hemichorea/hemiballism and topiramate

Although vascular hemichorea/hemiballism (HC/HB) has been reported to be self-limited, in some cases, it can be irreversible and severely disabling. The standard treatment includes typical and atypical neuroleptics and GABA-mimetic drugs. Topiramate is a new antiepileptic drug possessing a complex mechanism of action, including the enhancement of GABA-mediated inhibition. We describe a 71-year-old patient with HC/HB who markedly improved after topiramate treatment. (C) 2004 Movement Disorder Society.