A 16-year-old woman was referred for consultation due to visual difficulties, «as a part of the girl I don’t see, especially since 3 weeks ago».
His mother says that 'he has changed from being an active girl to being lightened, with difficulty thinking, talking and now sees bad.'
Since the age of 7 years she has had seizures that are difficult to control.
Her treatment was carbamazepine, hydantoin and for 3 months Topamax 125 mg daily.
The last exploration performed one year earlier was normal.
Spontaneous visual acuity (VA) was 1 in both eyes, with normal anterior voiding biomics.
The pupils were isochoric and normoreactive.
Fundoscopy showed no abnormalities.
A non-concurrent left hemianopsia was observed in the computerized campimetry.
The color test showed no alterations in any eye.
A gadolinium-enhanced magnetic resonance imaging (MRI) of the brain was normal, as well as a diffusion-weighted MRI.
The rest of the neurological examination was normal.
The suspicion of a toxic phenomenon by Topamax was suspended progressively, with subjective improvement of the patient and partial recovery of the visual field.
