Chorea in a Chronic Pain Patient Using Gabapentin

Dmitri Souzdalnitski

Anita Chang

Maged Guirguis

^{Center for Pain Management, Summa Western Reserve Hospital, Cuyahoga Falls, OH}

^{Department of Psychiatry, Wayne State University, and Detroit Medical Center, Detroit, MI}

^{Department of Pain Management, Ochsner Clinic Foundation, New Orleans, LA}

Address correspondence to, Dmitri Souzdalnitski, MD, PhD, Center for Pain Management, Summa Western Reserve Hospital, 1900 23^{Street, Cuyahoga Falls, OH 44223, Tel: (330) 971-9246, Email:}gro.latipsohevresernretsew@ikstinladzuosd

Abstract

Background

Gabapentin increasingly is being used to treat chronic pain in addition to seizures, anxiety, and bipolar disorder. Chorea has been reported as a potential side effect of gabapentin.

Case Report

We report the case of a patient with chronic low back pain who was treated with a host of modalities, including gabapentin. After she increased her dose of gabapentin, she developed chorea of the upper extremities, neck, and head. With cessation of gabapentin, the bulk of her symptoms resolved within 24 hours, and symptoms completely resolved in the following months.

Conclusions

Chorea is thought to appear when the basal ganglia are deregulated. Gabapentin interferes with gamma-aminobutyric acid, the primary inhibitory neurotransmitter in the motor pathway. Chorea associated with gabapentin has been reported in several case studies, but not at a dose as low as the patient took in this case.

Keywords: Basal ganglia, chorea, chronic pain, drug-related side effects and adverse reactions, gabapentin, gamma-aminobutyric acid

Abstract

Footnotes

The authors have no financial or proprietary interest in the subject matter of this article.

Footnotes

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