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Pregabalin Toxicity Manifesting as Reversible Encephalopathy With Continuous Triphasic Waves in Electroencephalogram
Mihir Parekh1, Gopal Krishna Dash, Isthiaque Ahamed
1*Department of Neurology, and †Department of Nephrology, Narayana Health City, Bangalore, India.
Clinical Neuropharmacology
|September 19, 2017
Summary
A rare case shows that pregabalin (PBG) overdose can induce continuous triphasic waves (TWs) on electroencephalograms. Recovery occurred after discontinuing PBG, highlighting PBG
Area of Science:
- Neurology
- Clinical Neurophysiology
Background:
- Peripheral neuropathy in diabetics can be managed with pregabalin (PBG).
- Altered mental status can be a symptom of neurological conditions or drug toxicity.
Observation:
- A 74-year-old man with diabetic peripheral neuropathy deliberately ingested 450 mg of PBG over 8 hours.
- The patient presented with altered mental status, prompting an electroencephalogram (EEG).
Findings:
- Bedside EEG revealed continuous triphasic waves (TWs) with slow background activity.
- These EEG abnormalities resolved 48 hours after PBG cessation.
- Repeat EEG after 72 hours showed no residual TWs.
Implications:
- This case expands the known causes of triphasic waves, including drug-induced phenomena.
- Highlights the importance of considering PBG toxicity in patients with altered mental status and EEG changes.
- Underscores the diagnostic utility of EEG in evaluating drug-induced neurological effects.
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