Gabapentin as a rescue drug in D-penicillamine-induced status dystonicus in patients with Wilson disease

Paliwal, Vimal Kumar; Gupta, Pankaj; Pradhan, Sunil

doi:10.4103/0028-3886.72184

Cited by 28 publications

(21 citation statements)

References 7 publications

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“…23 The sedative effects of 'conventional' muscle relaxants and general sedative medication give dystonic children a very monotonous existence, either asleep with no symptoms or awake with terrible difficulties. In comparison, gabapentin may provide relief from a variety of symptoms without unduly compromising child alertness or ability to actively participate in daily life with sparse levels of side-effects: no patients discontinuing gabapentin for reported adverse effects.…”

Section: Discussionmentioning

confidence: 99%

Gabapentin can significantly improve dystonia severity and quality of life in children

Liow

Gimeno

Lumsden

et al. 2016

European Journal of Paediatric Neurology

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Section: Discussionmentioning

confidence: 99%

Gabapentin can significantly improve dystonia severity and quality of life in children

Liow

Gimeno

Lumsden

et al. 2016

European Journal of Paediatric Neurology

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“…Other reports, however, could not confirm a beneficial effect for levetiracetam [22,23]. There are also reports of the successful use of gabapentin for D-penicillamine-induced status dystonicus in patients with Wilson disease [24].…”

Section: Antiepileptic Medicationsmentioning

confidence: 96%

Treatment of Generalized Dystonia

Lubarr

Bressman

2011

Curr Treat Options Neurol

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The armamentarium for clinicians treating patients with generalized dystonia, previously restricted to only a few oral medications that often caused intolerable side effects, has been radically expanded in the past decade with the widespread application of deep brain stimulation (DBS). With DBS, patients who in the past would have been restricted to a life of severe motor disability from a young age can now lead lives with only minimal symptoms. Although DBS should therefore be considered as a treatment option for any patient with severe, medically refractory dystonia, important questions remain about patient selection, including what factors predict which patients will benefit from DBS, and when in the course of disease DBS should be performed. Reports show that patients with primary dystonia respond better than those with secondary dystonia, and limb and axial muscles may improve more than cranial dystonia. Some studies also suggest that shorter duration of disease may be associated with better outcomes. However, it is important to note that even among those thought to respond best to DBS, i.e. patients with primary generalized dystonia, there is a subset that will have significant and sustained clinical benefit with oral medications. It is therefore important that adequate trials of oral medications be attempted prior to referral for surgery. On the other hand, once it is clear that medical therapies are not providing significant benefit or are not well tolerated, children with disabling generalized primary dystonia should be referred quickly for DBS. The dramatic clinical improvement that can be seen with DBS can restore normal or near-normal functioning and avoid the physical and emotional costs of an extended period of decreased physical and social functioning. In general, a levodopa trial should always be considered as the first treatment at the time of presentation of any patient with childhood-onset limb dystonia, in order to exclude dopa-responsive dystonia. Once a diagnosis of primary generalized dystonia is established, we typically initiate treatment with trihexyphenidyl, titrating slowly up to a high dose. We then frequently add baclofen as a second agent. If clinical improvement at that point is inadequate and the dystonia is causing significant functional impairment, we then consider referral for DBS.

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“…[34] Gabapentin has been useful in d-penicillamine induced status dystonia. [35] A study from Eastern India with 34 children suffering from WD shows that the mean age of the children was 7.7 ± 2.13 years. About 78.2% of cases responded to medical treatment.…”

Section: Dystoniamentioning

confidence: 99%

Movement disorders: Indian scenario: A clinico-genetic review

et al. 2013

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Movement disorder (MD) is an important branch of neurology and has great potentiality in management because of improved diagnosis and therapeutic strategies. Over the last three decades, emphasis has been laid on the evaluation of various MDs in India by a limited number of interested neurologists and basic scientists. In this review, we want to highlight common problems of MDs in India with regard to epidemiology, clinical features and genetics.

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Gabapentin as a rescue drug in D-penicillamine-induced status dystonicus in patients with Wilson disease

Cited by 28 publications

References 7 publications

Gabapentin can significantly improve dystonia severity and quality of life in children

Gabapentin can significantly improve dystonia severity and quality of life in children

Treatment of Generalized Dystonia

Movement disorders: Indian scenario: A clinico-genetic review

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