Asterixis related to gabapentin as a cause of falls

Negative myoclonus, commonly known as asterixis, is often observed in patients with toxic-metabolic encephalopathies or focal brain lesions. It is a movement disorder characterized by postural lapses resulting from brief cessation of tonic muscular contraction. Negative myoclonus has a characteristic appearance on needle electromyography. Lapses in continuous postural muscle activity can lead to falls. This increased risk of falls makes it particularly important to recognize and treat negative myoclonus, especially in patients with multiple medical problems, deconditioning, and gait disturbances. To our knowledge, there have been no published reports implicating negative myoclonus as a cause of falls in adults. We present a case of asterixis as a cause of falls and near falls in a patient with metastatic breast cancer and normal mental status who was receiving gabapentin.