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Bei Patienten, die eine nicht zu erklrende Lethargie oder Vernderungen des mentalen Zustands im Zusammenhang mit einer Topiramat-Monotherapie oder -Zusatztherapie entwickeln, wird empfohlen, eine hyperammonmische Enzephalopathie in Betracht zu ziehen und die Ammoniakspiegel zu messen

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Many of these compounds interact with immune pathways and peripheral systems, making it difficult to attribute observed effects solely to the modulation of angiogenesis within the CNS

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