A Case of Gabapentin-induced Myoclonus in a Type 2 Diabetic Patient with End-stage Renal Disease

Eun Yeong Choe; Byung-Wan Lee; Kyeong Hye Park; Hannah Seok; Daham Kim; Eun Seok Kang; Bong Soo Cha; Hyun Chul Lee

doi:10.4093/jkd.2011.12.3.171

Journal List > J Korean Diabetes > v.12(3) > 1054788

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Choe, Lee, Park, Seok, Kim, Kang, Cha, and Lee: A Case of Gabapentin-induced Myoclonus in a Type 2 Diabetic Patient with End-stage Renal Disease

Original Articles & Case Reports

J Korean Diabetes 2011;12(3):171-173.

Published online: 22 January 2011

DOI: https://doi.org/10.4093/jkd.2011.12.3.171

A Case of Gabapentin-induced Myoclonus in a Type 2 Diabetic Patient with End-stage Renal Disease

Eun Yeong Choe, Byung-Wan Lee, Kyeong Hye Park, Hannah Seok, Daham Kim, Eun Seok Kang, Bong Soo Cha, Hyun Chul Lee

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Development of myoclonus can manifest as a side effect of antiepileptic drugs in subjects with preexisting epilepsy, post-traumatic brain injury, encephalopathy, or focal and multifocal brain lesions. A 69-year-old male showed new onset severe myoclonus and confusion two days after taking 1200 mg gabapentin. The patient had end-stage renal disease secondary to type 2 diabetes and was receiving hemodialysis twice a week. After increasing hemodialysis to three times a week and discontinuing gabapentin, myoclonus spontaneously resolved. Here we report the first case of myoclonus in a Korean subject with diabetic renal failure. We recommend caution in the administration of gabapentin for diabetic subjects with renal disease.

Keywords: Gabapentin, Myoclonus, Diabetic neuropathies, Chronic renal failure

REFERENCES

1. Scullin P, Sheahan P, Sheila K. Myoclonic jerks associated with gabapentin. Palliat Med. 2003; 17:717–8.

2. Healy DG, Ingle GT, Brown P. Pregabalin- and gabapentin-associated myoclonus in a patient with chronic renal failure. Mov Disord. 2009; 24:2028–9.

3. Asconapé J, Diedrich A, DellaBadia J. Myoclonus associated with the use of gabapentin. Epilepsia. 2000; 41:479–81.

4. Zhang C, Glenn DG, Bell WL, O'Donovan CA. Gabapentin-induced myoclonus in end-stage renal disease. Epilepsia. 2005; 46:156–8.

5. Han SW, Kim SY, Chu MK, Yu KH, Kim YJ, Lee BC, Kim J. Gabapentin-induced myoclonus in a patient with end-stage renal disease. J Korean Neurol Assoc. 2006; 24:495–7.

6. Cho KT, Hong SK. Myoclonus induced by the use of gabapentin. J Korean Neurosurg Soc. 2008; 43:237–8.

7. Mercadante S, Villari P, Fulfaro F. Gabapentin for opiod-related myoclonus in cancer patients. Support Care Cancer. 2001; 9:205–6.

8. Huppertz HJ, Feuerstein TJ, Schulze-Bonhage A. Myoclonus in epilepsy patients with anticonvulsive add-on therapy with pregabalin. Epilepsia. 2001; 42:790–2.

9. Pranzatelli MR. Serotonin and human myoclonus. Rationale for the use of serotonin receptor agonists and antagonists. Arch Neurol. 1994; 51:605–17.

10. Suzuki R, Rahman W, Rygh LJ, Webber M, Hunt SP, Dickenson AH. Spinal-supraspinal serotonergic circuits regulating neuropathic pain and its treatment with gabapentin. Pain. 2005; 117:292–303.

11. Rao ML, Clarenbach P, Vahlensieck M, Kr?tzschmar S. Gabapentin augments whole blood serotonin in healthy young men. J Neural Transm. 1988; 73:129–34.

12. Pappert EJ, Goetz CG, Stebbins GT, Belden M, Carvey PM. 5-Hydroxytryptophan-induced myoclonus in guinea pigs: mediation through 5-HT1/2 receptor subtypes. Eur J Pharmacol. 1998; 347:51–6.

13. Welsh JP, Placantonakis DG, Warsetsky SI, Marquez RG, Bernstein L, Aicher SA. The serotonin hypothesis of myoclonus from the perspective of neuronal rhythmicity. Adv Neurol. 2002; 89:307–29.

14. Argoff CE, Cole BE, Fishbain DA, Irving GA. Diabetic peripheral neuropathic pain: clinical and quality-of-life issues. Mayo Clin Proc. 2006; 81(4 Suppl):S3–11.

15. Boulton AJ, Malik RA, Arezzo JC, Sosenko JM. Diabetic somatic neuropathies. Diabetes Care. 2004; 27:1458–86.

16. Backonja M, Beydoun A, Edwards KR, Schwartz SL, Fonseca V, Hes M, LaMoreaux L, Garofalo E. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA. 1998; 280:1831–6.

17. Backonja M, Glanzman RL. Gabapentin dosing for neuropathic pain: evidence from randomized, placebo-controlled clinical trials. Clin Ther. 2003; 25:81–104.

TOOLS

Similar articles