加巴喷丁缓解周期性前庭小脑共济失调性眩晕：3 例及可能机制。
Gabapentin Relieves Vertigo of Periodic Vestibulocerebellar Ataxia: 3 Cases and Possible Mechanism.
机构信息
Wilmington, North Carolina, USA.
Dr. John T. Macdonald Foundation Department of Human Genetics, Department of Neurology, Hussman Institute for Human Genomics, Miller School of Medicine, University of Miami, Miami, Florida, USA.
出版信息
Mov Disord. 2021 May;36(5):1264-1267. doi: 10.1002/mds.28491. Epub 2021 Jan 16.
OBJECTIVE
The aim of this study was to report relief of optokinetic-triggered vertigo (OKTV) with low-dose gabapentin in three patients with periodic vestibulocerebellar ataxia [episodic ataxia type 4 (EA4); OMIM 606552].
METHODS
Clinical observations and analysis of video-recorded eye movements were used before and after gabapentin.
RESULTS
Gabapentin relieved vertigo of all three treated patients with EA4, particularly during activities that typically would induce vertiginous symptoms. Two patients reported 8-12 hours of sustained relief after the first 100 mg dose. One has benefited from 100-200 mg TID for 7 years. Video analysis of nystagmus revealed improved target tracking on smooth pursuit and a steadier gaze hold.
CONCLUSIONS
Gabapentin effectively relieved the optokinetic-triggered vertigo in our patients with EA4. Mechanisms are postulated in terms of known tight gabapentin binding to the Purkinje cell voltage-gated calcium channel. The observations may offer insight into this rare disease's neuropathology. © 2021 International Parkinson and Movement Disorder Society.
目的
本研究旨在报告三例周期性前庭小脑共济失调（发作性共济失调 4 型[EA4]；OMIM 606552）患者使用小剂量加巴喷丁后，对视动性眩晕（OKTV）的缓解情况。
方法
使用加巴喷丁前后的临床观察和视频记录眼动分析。
结果
加巴喷丁缓解了所有 3 例 EA4 治疗患者的眩晕，尤其是在通常会引起眩晕症状的活动中。2 例患者在首次服用 100mg 后 8-12 小时持续缓解。1 例患者已受益于每日 3 次、每次 100-200mg 的治疗 7 年。对眼震的视频分析显示，在平稳追踪和凝视稳定性方面，目标跟踪得到改善。
结论
加巴喷丁能有效缓解 EA4 患者的视动性眩晕。机制推测与加巴喷丁与浦肯野细胞电压门控钙通道的紧密结合有关。这些观察结果可能为这种罕见疾病的神经病理学提供了一些见解。 © 2021 国际帕金森病和运动障碍学会。
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