Combination therapy of levetiracetam and pregabalin to treat juvenile myoclonic epilepsy occurring during treatment of neuropathic pain

UCHIYAMA Tomohiro, AKINAGA Yasutsugu, IMAI Ryo, YAMAMOTO Yoko

doi:10.11321/jjspc.17-0033

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Other Title

神経障害性疼痛治療中に若年性ミオクロニーてんかんを発症しレベチラセタムとプレガバリンの併用療法を行った1症例
症例神経障害性疼痛治療中に若年性ミオクロニーてんかんを発症しレベチラセタムとプレガバリンの併用療法を行った1症例
ショウレイシンケイショウガイセイトウツウチリョウチュウニジャクネンセイミオクロニーテンカンオハッショウシレベチラセタムトプレガバリンノヘイヨウリョウホウオオコナッタ 1 ショウレイ

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<p>We present a case of juvenile myoclonic epilepsy (JME) that occurred during pregabalin therapy for neuropathic pain. Pregabalin administration was discontinued, but a subsequent combination of levetiracetam and pregabalin suppressed epileptic seizures and, eventually, pain. A 16-year-old girl reported prolonged, intermittent pain in the area of innervation associated with trocar penetration after treatment of a spontaneous pneumothorax with a trocar catheter. Treatment with pregabalin was effective, but unintended movements of the limbs became apparent. Although the pregabalin was temporarily interrupted, electroencephalography examination revealed spikes and slow wave complexes in general; the patient was diagnosed with JME. As a result, administration of levetiracetam was initiated and pregabalin could be recovered to its previous level. One of the side effects of pregabalin is involuntary movements such as myoclonus; a similar drug, gabapentin, is known to deteriorate JME with single-agent administration. Myoclonus and epileptic seizures are similar and we had difficulty in diagnosis and treatment; however, combination therapy was able to achieve compatibility between pain management and epileptic disease treatment.</p>

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Journal of Japan Society of Pain Clinicians

Journal of Japan Society of Pain Clinicians 25 (2), 81-85, 2018-06-25

Japan Society of Pain Clinicians

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