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Gabapentin opens window of communication

Date:
June 21, 2010
Source:
Mayo Clinic
Summary:
For patients with quadriplegia, mutism and lower cranial nerve paralysis (locked-in syndrome), their only means of interacting with others is through vertical gaze and upper eyelid movements, using eye-coded communication strategies.

For patients with quadriplegia, mutism and lower cranial nerve paralysis (locked-in syndrome), their only means of interacting with others is through vertical gaze and upper eyelid movements, using eye-coded communication strategies.

In the June issue of Mayo Clinic Proceedings, researchers from Italy describe four patients with locked-in syndrome who also had dancing eye syndrome (opsoclonus-myoclonus syndrome). Because these patients' eyes spontaneously and continuously oscillated in a variety of directions beyond their control, they could no longer interact with family members, physicians or other people.

The lead author, Francesca Pistoia, M.D., University of L'Aquila, Italy, reports that a decision was made to treat these patients with daily continuous gabapentin therapy based on a previous successful experience. Gabapentin was started as a single 300 mg dose on the first day followed by 600 milligrams per day in divided doses on the second day. In two of the patients, this dosage reduced ocular symptoms, and communication and quality of life improved. For the other two patients, the dose was further increased, with the best response achieved with a daily 1,200 mg dose.

In all four patients, attempts to stop treatment resulted in recurrence of dancing eye symptoms six hours after the last dose. Thus, gabapentin use was promptly resumed. Researchers found none of the patients experienced adverse effects from the treatment.

In an accompanying editorial, Joseph Sirven, M.D., Mayo Clinic neurologist, discusses the off-label use of gabapentin, which was approved by the U.S. Food and Drug Administration in 1994 for use as an adjunctive medication to control partial seizures. Dr. Sirven writes, "Ironically, despite the fact that the drug was invented and synthesized for its use in seizure prevention, its smallest market today is epilepsy and seizures."

"The study by Pistoia and colleagues has a potential profound impact for treatment of patients with locked-in syndrome and opsoclonus-myoclonus syndrome," writes Dr. Sirven. "Because this neurologic condition is so rare, small observational studies serve as the main source of clinical evidence and could be the cornerstone for clinical practice with no other evidence."


Story Source:

The above story is based on materials provided by Mayo Clinic. Note: Materials may be edited for content and length.


Journal References:

  1. F. Pistoia, M. Conson, M. Sara. Opsoclonus-Myoclonus Syndrome in Patients With Locked-in Syndrome: A Therapeutic Porthole With Gabapentin. Mayo Clinic Proceedings, 2010; 85 (6): 527 DOI: 10.4065/mcp.2010.0042
  2. J. I. Sirven. New Uses for Older Drugs: The Tales of Aspirin, Thalidomide, and Gabapentin. Mayo Clinic Proceedings, 2010; 85 (6): 508 DOI: 10.4065/mcp.2010.0267

Cite This Page:

Mayo Clinic. "Gabapentin opens window of communication." ScienceDaily. ScienceDaily, 21 June 2010. <www.sciencedaily.com/releases/2010/06/100616171645.htm>.
Mayo Clinic. (2010, June 21). Gabapentin opens window of communication. ScienceDaily. Retrieved September 30, 2014 from www.sciencedaily.com/releases/2010/06/100616171645.htm
Mayo Clinic. "Gabapentin opens window of communication." ScienceDaily. www.sciencedaily.com/releases/2010/06/100616171645.htm (accessed September 30, 2014).

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