| Pregabalin-withdrawal encephalopathy and splenial edema: a link to high-altitude illness? | |
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MedLine Citation:
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PMID: 15991228 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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A postherpetic-neuralgia patient abruptly discontinued pregabalin. Thirty hours later, unexplained nausea, headache, and ataxia developed, progressing to delirium 8 days later. Magnetic resonance imaging indicated T2-hyperintense lesions of her splenium. Similar magnetic resonance imaging abnormalities, interpreted as focal vasogenic edema, develop in some epileptic patients after rapid anticonvulsant withdrawal. Patients with high-altitude cerebral edema have similar splenial-predominant magnetic resonance imaging abnormalities that accompany these same neurological symptoms. This case is the first to associate anticonvulsant-withdrawal splenial abnormalities with neurological symptoms, with gabapentin-type anticonvulsants, and is among the first in nonepileptic patients, suggesting that sudden anticonvulsant withdrawal alone, unaccompanied by seizures, can initiate symptomatic focal brain edema. The similarity of this syndrome to high-altitude cerebral edema suggests a possible common pathophysiology and offers potential therapies. |
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Authors:
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Anne Louise Oaklander; Bradley R Buchbinder |
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Publication Detail:
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Type: Case Reports; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Annals of neurology Volume: 58 ISSN: 0364-5134 ISO Abbreviation: Ann. Neurol. Publication Date: 2005 Aug |
Date Detail:
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Created Date: 2005-08-02 Completed Date: 2005-10-31 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 7707449 Medline TA: Ann Neurol Country: United States |
Other Details:
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Languages: eng Pagination: 309-12 Citation Subset: IM |
Affiliation:
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Nerve Injury Unit, Department of Anesthesiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA. aoaklander@partners.org |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Altitude Sickness / physiopathology Anticonvulsants* / administration & dosage Brain Edema / etiology*, pathology Female Humans Magnetic Resonance Imaging / methods Neuroglia / drug effects Substance Withdrawal Syndrome / complications*, etiology Time Factors gamma-Aminobutyric Acid / administration & dosage, analogs & derivatives* |
| Grant Support | |
ID/Acronym/Agency:
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R01NS42866/NS/NINDS NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Anticonvulsants; 0/pregabalin; 56-12-2/gamma-Aminobutyric Acid |
| Comments/Corrections | |
Comment In:
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Ann Neurol. 2006 Jan;59(1):214
[PMID:
16374825
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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