Reactions 1485, p21 - 25 Jan 2014

SGabapentin

Choreoathetosis in an elderly patient: case reportA 74-year-old woman developed choreoathetosis while

receiving gabapentin for painful tonic spasms (PTS) associatedwith neuromyelitis optica spectrum disorder [NMOSD; routenot stated].

The woman was diagnosed with NMOSD and initiallytreated with methylprednisolone. Due to the development ofPTS, she began receiving carbamazepine. Her PTS improved,but she developed thrombocytopenia. Two days afterswitching from carbamazepine to gabapentin 400 mg/day, shedeveloped choreoathetotic movement in her left arm.

The dosage of gabapentin was increased to 600 mg/day, butthe woman’s PTS and choreoathetosis did not improve. Herserum trough concentration of gabapentin was 4.08 mg/mL.Gabapentin was discontinued. Two days later, her serumconcentration of gabapentin decreased to 0.23 mg/dL and herchoreoathetosis disappeared.

Author comment: "Gabapentin enhances gammaaminobutyric acid (GABA) synthesis and inhibits GABAdegradation. . . [T]he choreoathetosis emerged after takinggabapentin and was accompanied by PTS. We suggest thatmodification of the GABA receptor activity and the cervicalgray matter lesion had a role in the development ofchoreoathetosis."Sugeno N, et al. Choreoathetosis in a patient with neuromyelitis optica spectrumdisorder. Neurology and Clinical Neuroscience 1: 154-156, No. 4, Jul 2013.Available from: URL: http://dx.doi.org/10.1111/ncn3.36 - Japan 803098399

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Reactions 25 Jan 2014 No. 14850114-9954/14/1485-0001/$14.95 Adis © 2014 Springer International Publishing AG. All rights reserved