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普瑞巴林诱发的帕金森综合征:一例报告

Pregabalin-induced parkinsonism: a case report.

作者信息

Perez Lloret Santiago, Amaya Mariela, Merello Marcelo

机构信息

Movement Disorders Section, Neuroscience Department, Institute for Neurological Research Raul Carrea FLENI, Montañeses 2325, Buenos Aires, Argentina.

出版信息

Clin Neuropharmacol. 2009 Nov-Dec;32(6):353-4. doi: 10.1097/WNF.0b013e3181a9eb1b.

Abstract

BACKGROUND

: 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.

CASE REPORT

: 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 Pregabalin was withdrawn.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.

CONCLUSION

: 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.

摘要

背景

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。

病例报告

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。

结论

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。

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