Painful Diabetic Peripheral Neuropathy Relieved With Use of Oral Topiramate

Kristina M. Kline, MD, Dana G. Carroll, PHARMD, Karen F. Malnar, RN, CTR, CCRC


South Med J. 2003;96(6) 

In This Article

Abstract and Introduction

Diabetic peripheral neuropathy affects 5 to 50% of people with diabetes in the United States. It is a progressive disorder that results in a gradual decrease in peripheral sensation and eventually complete loss of sensation. Patients with diabetic peripheral neuropathy are challenging to treat because of intolerable adverse medication effects and the development of tolerance to medical treatment. We present the case of a patient with peripheral neuropathy that was unresponsive to usual therapies. She experienced significant relief with the administration of topiramate. Topiramate is an anticonvulsant that is gaining recognition in the treatment of patients with neuropathic pain syndromes.

Peripheral neuropathy affects 5 to 50% of people with diabetes in the United States.[1] Peripheral neuropathy typically affects the lower extremities of diabetic patients and is characterized by an initial bilateral tingling or burning sensation that spontaneously increases or decreases in intensity over time. Patients may describe the pain associated with peripheral neuropathies as dull, cold, burning, crushing, aching, cramping, or tingling. Patients with diabetic peripheral neuropathies may have a heightened sensitivity to stimuli such as touch, temperature changes, or application of external pressure that results in excruciating pain with the slightest changes. The pain associated with peripheral neuropathy usually is more intense at night than during the day. Diabetic peripheral neuropathy is a progressive disorder and results in a gradual decrease in peripheral sensation with eventual complete loss of sensations to heat, cold, pressure, or pain.[1,2]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.