Perez Lloret Santiago, Amaya Mariela, Merello Marcelo
Movement Disorders Section, Neuroscience Department, Institute for Neurological Research Raul Carrea FLENI, Montañeses 2325, Buenos Aires, Argentina.
Clin Neuropharmacol. 2009 Nov-Dec;32(6):353-4. doi: 10.1097/WNF.0b013e3181a9eb1b.
: Pregabalin (PGB) is an L-type, voltage-dependent, calcium-channel blocker, useful for the treatment of neuropathy pain and some forms of seizures. We report the case of a 64-year-old woman who developed full-blown parkinsonism after PGB administration.
: A female patient who developed diabetic sensory-motor polyneuropathy began treatment with gabapentin 300 mg plus amitriptyline 25 mg at the age of 56 years, with good tolerance. Eight years later, PGB 150 mg was added, after 3 months she developed a parkinsonian-like syndrome with axial symptoms, bilateral symmetric postural tremor, bradykinesia, and rigidity in both upper and lower limbs. Unified Parkinson's Disease Rating Scale motor score was 27/108 points at this time. Clear link to PGB introduction as well as symmetric limb involvement and symptom intensity made us suspect drug-induced parkinsonism. Pregabalin was withdrawn. Six months later, the patient had almost completely recovered; her Unified Parkinson's Disease Rating Scale motor score dropped to 4/108; and 3 months after that, it was 0.
: Although some cases of tremor were reported in clinical trials on PGB, to our knowledge, this is the first report of full-blown parkinsonism associated with PGB use. Vigilance of PGB-treated patients is recommended.
普瑞巴林（PGB）是一种L型、电压依赖性钙通道阻滞剂，可用于治疗神经病理性疼痛和某些类型的癫痫。我们报告了一例64岁女性在服用普瑞巴林后出现典型帕金森病的病例。
一名患有糖尿病感觉运动性多发性神经病变的女性患者，56岁时开始服用加巴喷丁300毫克加阿米替林25毫克进行治疗，耐受性良好。八年后，加用普瑞巴林150毫克，3个月后她出现了类似帕金森综合征的症状，包括轴性症状、双侧对称性姿势性震颤、运动迟缓以及双上肢和双下肢僵硬。此时统一帕金森病评定量表运动评分为27/108分。普瑞巴林的使用与症状的明确关联、肢体对称性受累以及症状严重程度使我们怀疑为药物性帕金森病。停用普瑞巴林。六个月后，患者几乎完全康复；她的统一帕金森病评定量表运动评分降至4/108分；此后三个月，评分变为0分。
尽管在普瑞巴林的临床试验中报告了一些震颤病例，但据我们所知，这是首例与使用普瑞巴林相关的典型帕金森病报告。建议对接受普瑞巴林治疗的患者保持警惕。
