Sechi GianPietro, Murgia Bastianino, Sau GianFranco, Peddone Luigi, Tirotto Antonella, Barrocu Marianna, Rosati Giulio
Neurological Clinic, University of Sassari, Viale San Pietro, 10, 07100 Sassari, Italy.
Prog Neuropsychopharmacol Biol Psychiatry. 2004 Jan;28(1):195-9. doi: 10.1016/S0278-5846(03)00166-0.
To date, only one case of asterixis associated with the use of gabapentin (GBT) has been reported. No data, instead, are available on the occurrence of asterixis related to a dementing encephalopathy during GBT therapy in the elderly.
Case reports of two elderly patients, one with asterixis, the other with asterixis and encephalopathy, associated with the use of GBT, as adjunctive therapy, at dosages of 900 to 3600 mg/day are given. In one patient, GBT was added to oxcarbazepine (OXCBZ).
Both patients experienced resolution of the clinically apparent asterixis, and of the toxic encephalopathy, on discontinuation or reduction of GBT dosages. One patient developed asterixis after drug rechallenge. In the patient on OXCBZ, the analysis of the electromyogram (EMG) activity showed the occurrence of a subclinical asterixis.
Our study indicates that high doses of GBT may induce asterixis related to a reversible encephalopathy. Low doses of GBT, instead, may induce a disabling asterixis when given in combination with OXCBZ because of a synergistic interaction between these drugs.
迄今为止，仅报道过1例与加巴喷丁（GBT）使用相关的扑翼样震颤病例。然而，关于老年患者在GBT治疗期间发生与痴呆性脑病相关的扑翼样震颤，尚无相关数据。
给出了2例老年患者的病例报告，1例有扑翼样震颤，另1例有扑翼样震颤和脑病，均与作为辅助治疗使用GBT有关，剂量为900至3600毫克/天。在1例患者中，GBT添加至奥卡西平（OXCBZ）治疗方案中。
2例患者在停用或减少GBT剂量后，临床上明显的扑翼样震颤及中毒性脑病均得到缓解。1例患者在药物再次激发后出现扑翼样震颤。在接受OXCBZ治疗的患者中，肌电图（EMG）活动分析显示存在亚临床扑翼样震颤。
我们的研究表明，高剂量的GBT可能诱发与可逆性脑病相关的扑翼样震颤。相反，低剂量的GBT与OXCBZ联合使用时，可能因这些药物之间的协同相互作用而诱发致残性扑翼样震颤。
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