NANOSNET

I have an 18 yo pt who for the last 1-2 yrs has been experiencing visual disturbances almost like things are "moving in slow motion, or fish-eye like in a concave/convex mirror, sometimes in association with light sensitivity". 

I have characterized it generally as possible persistent visual aura related to alice-in-wonderland syndrome. She did not respond to any CGRP or typical migrainous therapies such as topamax/propranolol, but then had a marked response to lamictal w/near complete resolution for the last several months, but has been having significant tolerance issues w/the med and wants to try something different. She does appear to have dose-responsiveness to the lamictal. 

Does anyone have any suggestions for another similar med that might treat 'persistent visual aura' in this way similar to lamictal? I'm wondering about possible oxcarbazepine or vimpat?

thanks,

Nathan

I have had good success with such symptoms using nortriptyline.