Myoclonus in epilepsy patients with anticonvulsive add-on therapy with pregabalin.
OBJECTIVE
To report on the occurrence of myoclonus in patients receiving pregabalin (PGB) for the treatment of focal epilepsy.


METHODS
Clinic records of 19 patients who were consecutively enrolled at a tertial referral epilepsy center in a randomized, double-blind and/or open add-on study with PGB were reviewed.


RESULTS
In four patients treated with PGB, focal myoclonus newly developed. The side effect appeared with PGB doses of 50-600 mg/day; the intensity showed some dose dependency. All patients had medically refractory focal epilepsy and received other antiepileptic drugs (AEDs) besides the study medication. One patient showed focal myoclonic jerks of the left arm, whereas the other patients developed multifocal myoclonus. Polygraphic studies including electromyogram (EMG)-triggered back-averaging of the EEG in the patient with the highest frequency of myoclonic jerks showed no visible correlate of the myoclonus. In this patient, frequency and intensity of myoclonic jerks significantly decreased after dose reduction of PGB. In the other cases, myoclonus was only subtle and did not significantly interfere with daily activities, so that a dose reduction of PGB was not considered necessary.


CONCLUSIONS
These data indicate a relatively high incidence (four of 19) of myoclonus associated with PGB therapy. The rate seems to be at least as high as reported in patients receiving the structurally similar anticonvulsant gabapentin.
Huppertz
H J
HJ
Epilepsy Center, Department of Neurology, University of Freiburg, Breisacher Str. 64, D-79106 Freiburg, Germany. huppertz@nz.ukl.uni-freiburg.de
Feuerstein
T J
TJ
Schulze-Bonhage
A
A
D000085:Acetates / Q000009:adverse effects / Q000737:chemistry; D000328:Adult; D000588:Amines; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D002986:Clinical Trials as Topic / Q000706:statistics & numerical data; D003509:Cyclohexanecarboxylic Acids; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D004576:Electromyography; D004828:Epilepsies, Partial / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D000077206:Gabapentin; D005858:Germany / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D009207:Myoclonus / Q000139:chemically induced* / Q000453:epidemiology; D000069583:Pregabalin; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects* / Q000031:analogs & derivatives / Q000627:therapeutic use
D000085:Acetates; D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D000069583:Pregabalin; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin