Chorea in a chronic pain patient using gabapentin

Area of Science:

• Neurology
• Pharmacology

Background:

• Gabapentin is increasingly prescribed for chronic pain, anxiety, and seizures.
• Chorea, a movement disorder, has been identified as a potential adverse effect of gabapentin therapy.

Observation:

• A patient with chronic low back pain developed chorea affecting the upper extremities, neck, and head after increasing gabapentin dosage.
• The choreiform movements significantly improved within 24 hours of gabapentin cessation and fully resolved over subsequent months.

Findings:

• The case demonstrates chorea occurrence in a patient treated with gabapentin for chronic pain.
• This adverse event was observed at a relatively low gabapentin dose, suggesting increased sensitivity or a specific patient response.

Implications:

• Gabapentin's mechanism involves interference with gamma-aminobutyric acid, potentially disrupting basal ganglia function and leading to chorea.
• Clinicians should be vigilant for chorea as a potential side effect of gabapentin, even at lower therapeutic doses, particularly in patients with chronic pain.