Chorea associated with gabapentin use in an elderly man

Area of Science:

• Geriatric Medicine
• Neurology
• Pharmacology

Background:

• Chorea is a hyperkinetic movement disorder often associated with Huntington's disease or drug-induced causes.
• Gabapentin-induced chorea is not well-documented, particularly in elderly patients treated for anxiety.

Observation:

• An elderly male patient developed choreiform movements after initiating gabapentin for anxiety.
• The patient exhibited involuntary movements affecting the neck, trunk, extremities, and tongue.
• Symptoms emerged after more than a month of consistent gabapentin use.

Findings:

• The chorea resolved completely within two days of discontinuing gabapentin.
• Workup ruled out other common causes of chorea, such as vascular disease or dementia.
• This suggests gabapentin was the probable cause of the chorea.

Implications:

• This case underscores the importance of considering gabapentin as a potential cause of chorea in elderly patients.
• Clinicians should be vigilant for this rare adverse drug reaction when prescribing gabapentin.
• Further research may be warranted to understand the mechanism of gabapentin-induced chorea.