Neurology
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Randomized Controlled Trial Multicenter Study Comparative Study Clinical Trial
Topiramate vs placebo in painful diabetic neuropathy: analgesic and metabolic effects.
Using identical methods, three simultaneous placebo-controlled trials of topiramate for painful diabetic neuropathy (PDN) did not reach significance. This independent yet concurrent placebo-controlled trial used different methods to assess topiramate efficacy and tolerability in PDN. ⋯ Topiramate monotherapy reduced pain and body weight more effectively than placebo in patients with painful diabetic neuropathy.
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Allodynia, a manifestation of central sensitization, is not routinely evaluated during clinical interviews even though its therapeutic implications are known. ⋯ Clinically detectable allodynia, which occurs with high frequency in migraineurs, should become part of the clinical evaluation because of its implications in early treatment with triptans, recurrence of headache, consistency of response to triptans, and development of chronicity of migraine.