Objective: The aim of this study was to present myoclonus as a reversible side effect of gabapentin in order to bring this trend to clinician’s attention to avoid unnecessary tests and aggressive management.

Background: Gabapentin (GBP) is an approved molecule that has been used for treatment of an array of conditions such as focal seizures and various pain syndromes. Although, some recent studies have reported that this drug may induce myoclonus in patients with impaired renal function, this side effect remained unkown in clinical practice.

Method: Clinical, biological and neuro-imaging findings were collected in a patient who consulted for myoclonus.

Results: We report the case of a seventy-two year old woman, with a medical history of diabetes mellitus and impaired renal function.  She presented with severe brief jerks of all extremities resulting in repeated falls. Her husband mentioned that she had consulted her diabetes specialist for painful sensorimotor neuropathy, four days before presentation and was prescribed gabapentin 150 mg twice daily. Neurological examination showed a mental slowing with multifocal spontaneous myoclonic movements of the upper and lower limbs. Her Brain MRI and her electroencephalogram were unremarkable. Basic metabolic panel on admission showed increased creatinine of 311 mmol/L and blood urea nitrogen of 23mmol/L (normal range <7). The patient underwent emergency hemodialysis and after discontinuation of gabapentin for 24 h, the myoclonus disappeared and the patient was no longer mentally slow.

Conclusion: Despite the rarety of myoclonus as a reversible side effect of Gabapentin, this diagnosis should be considered in any patient with significant renal dysfunction who is started on gabapentin therapy and even in short period of time and with low dosage regardless of normal serum gabapentin levels.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gabapentin-induced-severe-myoclonus-in-a-patient-with-impaired-renal-function/