Disabling Asterixis Induced By Gabapentin

Abstract

We describe a case of an 80-year-old woman who developed disabling asterixis after taking gabapentin for post-herpetic neuropathy. She had end-stage renal disease necessitating intermittent hemodialysis for the previous 5 years. She had begun taking gabapentin about 1 week prior to being admitted to the hospital, and a family member observed a new tremor developing about 3 days prior to hospital admission. Neurologic examination revealed diffuse axial and appendicular negative myoclonus. Because of her renal dysfunction, the gabapentin dose was empirically reduced from 300 mg by mouth three times daily to 100 mg three times daily. Gabapentin was discontinued on hospital day 5 because of concerns for drug toxicity causing the abnormal movements. Two days after gabapentin was discontinued, she has complete resolution of her negative myoclonus.




J Med Cases. 2015;6(7):285-286
doi: http://dx.doi.org/10.14740/jmc2143w