title: Gabapentin can significantly improve dystonia severity and quality of life in children.
abstract: BACKGROUND
  Gabapentin has been used in the management of neuropathic pain, epilepsy and occasionally movement disorders.
  
  
  METHODS
  A four-year retrospective, observational study analysed the use of gabapentin for severe dystonia in children at the Evelina London Children's Hospital. Motor severity was classified according to the Gross Motor Function Classification System (GMFCS), Dystonia Severity Assessment Plan (DSAP) and levels of impairment in activities of daily living were graded according to the WHO International Classification of Functioning, Disability and Health, Children & Youth version (ICF-CY) before and after gabapentin.
  
  
  RESULTS
  The majority of the 69 children reported were level 5 GMFCS (non-ambulant). The DSAP grade fell significantly from grade 3 before to grade 1 after gabapentin. Significant improvements in median ICF-CY grades were seen following gabapentin in sleep quality, sleep amount, mood & agreeableness, pain, general muscle tone, involuntary muscle contractions and seating tolerance (p < 0.01 in all areas). A significantly higher mean dose of 18.1 mg/kg/dose (SD: 13.3) for dystonia, compared to 7.61 mg/kg/dose (SD: 4.14) for pain relief without dystonia (z = -2.54, p = 0.011) was noted.
  
  
  CONCLUSIONS
  Gabapentin may significantly ameliorate dystonia severity and improve activities of daily living and quality of life in children with severe dystonia.
authors.affiliation: Complex Motor Disorders Service, Children's Neurosciences Centre, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Natasha Yuan-Kim
authors.initials: NY
authors.lastname: Liow
authors.affiliation: Complex Motor Disorders Service, Children's Neurosciences Centre, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neurology, King's College London, UK.
authors.forename: Hortensia
authors.initials: H
authors.lastname: Gimeno
authors.affiliation: Complex Motor Disorders Service, Children's Neurosciences Centre, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Daniel Edward
authors.initials: DE
authors.lastname: Lumsden
authors.affiliation: Paediatric Pharmacy Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Marianczak
authors.affiliation: Complex Motor Disorders Service, Children's Neurosciences Centre, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK.
authors.forename: Margaret
authors.initials: M
authors.lastname: Kaminska
authors.affiliation: Paediatric Pharmacy Evelina London Children's Hospital, Guy's and St Thomas NHS Foundation Trust, London, UK.
authors.forename: Stephen
authors.initials: S
authors.lastname: Tomlin
authors.affiliation: Complex Motor Disorders Service, Children's Neurosciences Centre, Evelina London Children's Hospital, Guy's and St Thomas' NHS Foundation Trust, London, UK. Electronic address: Jean-Pierre.Lin@gstt.nhs.uk.
authors.forename: Jean-Pierre Sao-Ming
authors.initials: JP
authors.lastname: Lin
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000588:Amines / Q000627:therapeutic use*; D002648:Child; D003509:Cyclohexanecarboxylic Acids / Q000627:therapeutic use*; D004185:Disability Evaluation; D004421:Dystonia / Q000188:drug therapy; D020821:Dystonic Disorders / Q000188:drug therapy*; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use*; D005260:Female; D000077206:Gabapentin; D006801:Humans; D008297:Male; D011788:Quality of Life; D012189:Retrospective Studies; D005680:gamma-Aminobutyric Acid / Q000627:therapeutic use*
chemical_list: D000588:Amines; D003509:Cyclohexanecarboxylic Acids; D018691:Excitatory Amino Acid Antagonists; D005680:gamma-Aminobutyric Acid; D000077206:Gabapentin
keywords: Cerebral palsy; Children; Dystonia; Dystonia severity Assement Plan; Gabapentin; NBIA; WHO International Classification of function