Microseizures Induced by Topiramate.

A 22-year-old Japanese male with trisomy 21 was diagnosed with West syndrome at 4 months old. After the suppression of epileptic spasms using adrenocorticotropic hormone therapy, he had complex partial seizures and bilateral frontal epileptic discharges on EEG. Although the introduction of topiramate (TPM) decreased the seizures during wakefulness, frequent episodes of brief eye-opening appeared during sleep while the patient was taking TPM (400 mg/day).

Onset of polyarticular juvenile idiopathic arthritis with both anti-cyclic citrullinated peptide antibodies and rheumatoid factor in a 3-year-old girl.

This report describes 3 year old girl with the unusual presentation of polyarticular juvenile idiopathic arthritis (JIA) with anti-cyclic citrullinated peptide (anti-CCP) antibodies and a positive rheumatoid factor (RF). She was initially treated with a nonsteroidal anti-inflammatory drug (NSAID; ibuprofen) followed by methotrexate (MTX, 10 mg/m2/week) and prednisolone (0.25 mg/kg/day), but these treatments were ineffective.