Negative myoclonus associated with pregabalin

Area of Science:

• Neurology
• Pharmacology

Background:

• Negative myoclonus (NM) is characterized by sudden, brief interruptions in muscle contraction, presenting as jerky, shock-like involuntary movements.
• Neuropathic pain management often involves medications like pregabalin.

Observation:

• An 80-year-old male patient developed multifocal NM and confusion.
• The onset of NM occurred two days after initiating pregabalin (150 mg/day) for neuropathic pain.

Findings:

• Intravenous lorazepam administration and discontinuation of pregabalin resulted in complete resolution of NM.
• The patient's mental status gradually improved following these interventions.

Implications:

• This case suggests a potential causal link between pregabalin and negative myoclonus.
• Healthcare providers should consider pregabalin as a potential cause of NM, particularly in patients without a history of seizures.
• Awareness of this adverse effect is crucial for accurate diagnosis and management of involuntary movements in patients taking pregabalin.