title: Chorea in a chronic pain patient using gabapentin.
abstract: BACKGROUND
  Gabapentin increasingly is being used to treat chronic pain in addition to seizures, anxiety, and bipolar disorder. Chorea has been reported as a potential side effect of gabapentin.
  
  
  METHODS
  We report the case of a patient with chronic low back pain who was treated with a host of modalities, including gabapentin. After she increased her dose of gabapentin, she developed chorea of the upper extremities, neck, and head. With cessation of gabapentin, the bulk of her symptoms resolved within 24 hours, and symptoms completely resolved in the following months.
  
  
  CONCLUSIONS
  Chorea is thought to appear when the basal ganglia are deregulated. Gabapentin interferes with gamma-aminobutyric acid, the primary inhibitory neurotransmitter in the motor pathway. Chorea associated with gabapentin has been reported in several case studies, but not at a dose as low as the patient took in this case.
authors.affiliation: Center for Pain Management, Summa Western Reserve Hospital, Cuyahoga Falls, OH.
authors.forename: Dmitri
authors.initials: D
authors.lastname: Souzdalnitski
authors.affiliation: Department of Psychiatry, Wayne State University, and Detroit Medical Center, Detroit, MI.
authors.forename: Anita Kumar
authors.initials: AK
authors.lastname: Chang
authors.affiliation: Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA.
authors.forename: Maged
authors.initials: M
authors.lastname: Guirguis
keywords: Basal ganglia; chorea; chronic pain; drug-related side effects and adverse reactions; gabapentin; gamma-aminobutyric acid