Gabapentin-induced myoclonus in end-stage renal disease.
OBJECTIVE
We analyzed the occurrence and clinical features of myoclonus in patients with end-stage renal disease (ESRD) who were treated with gabapentin (GBP).


METHODS
We reviewed the medical records of patients with ESRD who were treated with GBP and hospitalized during an 18-month period and analyzed clinical details such as type of myoclonus, doses of GBP, electroencephalographic (EEG) findings, and relation of symptoms to GBP exposure and dosage.


RESULTS
Three of 71 patients had myoclonus with GBP doses ranging from 9 mg/kg to 20 mg/kg and within 4 months of treatment onset. Myoclonus was characterized as multifocal, involving all extremities in the three patients. EEG did not show epileptiform discharges with the myoclonus. Myoclonus resolved in the three individuals within 4-15 days after GBP was discontinued.


CONCLUSIONS
GBP increases the risk of myoclonus in ESRD. Myoclonus in these individuals was more disabling than that in patients with normal renal function, and discontinuation of GBP is required to restore normal function.
Zhang
Chunxiao
C
Department of Neurology, Wake Forest University Baptist Medical Center, Winston-Salem, North Carolina 27157, USA. czhang@wfubmc.edu
Glenn
Darren G
DG
Bell
William L
WL
O'Donovan
Cormac A
CA
D000328:Adult; D000588:Amines / Q000009:adverse effects*; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D003509:Cyclohexanecarboxylic Acids / Q000009:adverse effects*; D005260:Female; D000077206:Gabapentin; D006801:Humans; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced*; D010146:Pain / Q000188:drug therapy; D010292:Paresthesia / Q000188:drug therapy; D013035:Spasm / Q000188:drug therapy; D005680:gamma-Aminobutyric Acid / Q000009:adverse effects*
D000588:Amines; D000927:Anticonvulsants; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin