Yeungnam Univ J Med.  2018 Dec;35(2):240-243. 10.12701/yujm.2018.35.2.240.

Negative myoclonus associated with pregabalin

• Park KD
• Kim MK
• Lee SJ

• KMID: 2433747
• DOI: http://doi.org/10.12701/yujm.2018.35.2.240

Abstract

Negative myoclonus (NM) is a jerky, shock-like involuntary movement caused by a sudden, brief interruption of muscle contraction. An 80-year-old man presented with multifocal NM and confusion. Two days before the onset of NM, he commenced the intake of pregabalin at a dose of 150 mg/day for neuropathic pain. His NM resolved completely and mental status improved gradually after the administration of lorazepam intravenously and the discontinuation of pregabalin. Our study suggests that pregabalin can cause NM even in patients without a history of seizures.

Keyword

Myoclonus; Negative myoclonus; Pregabalin

MeSH Terms

Aged, 80 and over
Dyskinesias
Humans
Lorazepam
Muscle Contraction
Myoclonus*
Neuralgia
Pregabalin*
Seizures
Lorazepam
Pregabalin

Reference

1. Rubboli G, Tassinari CA. Negative myoclonus. An overview of its clinical features, pathophysiological mechanisms, and management. Neurophysiol Clin. 2006; 36:337–43.

2. Eberhardt O, Topka H. Myoclonic disorders. Brain Sci. 2017; 7:pii: E103.

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

4. Heckmann JG, Ulrich K, Dütsch M, Neundörfer B. Pregabalin associated asterixis. Am J Phys Med Rehabil. 2005; 84:724.

5. Knake S, Klein KM, Hattemer K, Wellek A, Oertel WH, Hamer HM, et al. Pregabalin-induced generalized myoclonic status epilepticus in patients with chronic pain. Epilepsy Behav. 2007; 11:471–3.

6. Hellwig S, Amtage F. Pregabalin-induced cortical negative myoclonus in a patient with neuropathic pain. Epilepsy Behav. 2008; 13:418–20.

7. Kim JB, Jung JM, Park MH, Lee EJ, Kwon DY. Negative myoclonus induced by gabapentin and pregabalin: a case series and systematic literature review. J Neurol Sci. 2017; 382:36–9.

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

9. Brefel-Courbon C, Gardette V, Ory F, Montastruc JL. Druginduced myoclonus: a French pharmacovigilance database study. Neurophysiol Clin. 2006; 36:333–6.

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

11. 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.

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