Responsiveness of life-threatening refractory emesis to gabapentin-scopolamine therapy following posterior fossa surgery. Case report.
Craniotomy-associated chronic emesis can be refractory to currently approved antiemetic therapy. The authors describe a man who suffered 4 weeks of severe refractory emesis, failure to thrive, and a 40-lb weight loss after he underwent resection of a posterior fossa cholesteatoma. The patient experienced complete resolution of emesis and anorexia in response to combined gabapentin-scopolamine therapy. This case provides anecdotal evidence for the use of gabapentin-scopolamine therapy in patients with chronic, refractory nausea and emesis, particularly following posterior fossa surgery, during which medullary nausea and emesis centers may be affected.
Guttuso
Thomas
T
Department of Neurology, School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York 14214, USA. tguttuso@buffalo.edu
Vitticore
Philip
P
Holloway
Robert G
RG
D000588:Amines / Q000008:administration & dosage*; D000932:Antiemetics / Q000008:administration & dosage*; D002781:Cholesteatoma / Q000601:surgery; D003388:Cranial Fossa, Posterior / Q000601:surgery*; D003509:Cyclohexanecarboxylic Acids / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D000077206:Gabapentin; D006801:Humans; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D012601:Scopolamine / Q000008:administration & dosage*; D014839:Vomiting / Q000188:drug therapy*; D005680:gamma-Aminobutyric Acid / Q000008:administration & dosage*
D000588:Amines; D000932:Antiemetics; D003509:Cyclohexanecarboxylic Acids; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin; D012601:Scopolamine