Reversal of phrenic nerve palsy with topiramate

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J Diabetes Complications. 2007 Jan-Feb;21(1):63-7.

Reversal of phrenic nerve palsy with topiramate.

Rice AL, Ullal J, Vinik AI.

Department of Internal Medicine, Strelitz Diabetes Institutes,

Eastern Virginia Medical School, Norfolk, VA 23510, USA.

A 57-year-old Caucasian man presented with diaphragmatic paralysis

and type 2 diabetes. He had severe orthopnea that remained unchanged

for 1 year. He was later diagnosed with distal symmetric

polyneuropathy and was started on topiramate. Within 26 weeks of

treatment, the patient showed improvement in diaphragmatic function

and regrowth of intraepidermal nerve fibers, accompanied by

improvement in respiratory and peripheral neuropathy symptoms.

Topiramate may prove to be an effective agent in the treatment of

nonremitting diaphragmatic paralysis and regrowth of intraepidermal

nerve fibers.