Pregabalin-withdrawal encephalopathy and splenial edema: A link to high-altitude illness?
Pregabalin-withdrawal encephalopathy and splenial edema: A link to high-altitude illness?
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DOI：
10.1002/ana.20583
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发表时间：
2005-08-01
影响因子：
11.2
通讯作者：
Buchbinder, BR
中科院分区：
文献类型：
--
作者：
Oaklander, AL;Buchbinder, BR
一位带状疱疹后神经痛患者突然停用普瑞巴林。30小时后，出现不明原因的恶心、头痛和共济失调，8天后进展为谵妄。磁共振显示她的脾有t2高强度病变。类似的磁共振成像异常，解释为局灶性血管源性水肿，出现在一些癫痫患者快速停药后。高原脑水肿患者有类似的脾为主的磁共振成像异常，并伴有相同的神经系统症状。该病例首次将抗惊厥停药后脾脏异常与神经系统症状和加巴喷丁型抗惊厥药联系起来，并且是首次在非癫痫患者中发现，这表明单独突然停药，不伴有癫痫发作，可引发症状性局灶性脑水肿。这种综合征与高原脑水肿的相似性提示可能存在共同的病理生理学，并提供潜在的治疗方法。
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.