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Second-generation antiepileptic drugs have created a new therapeutic option for chronic neuropathic pain. Gabapentin is one of the agents that is used very commonly, and has been shown to be safe and non-toxic. We report the case history of a 57-year-old woman with diabetes mellitus and uraemia on regular haemodialysis who developed severe dizziness and predominant lethargy after a single recommended dose of gabapentin for bilateral leg dysthesia.
CASE REPORT
A 57-year-old woman with diabetes mellitus and uraemia who was receiving regular haemodialysis three times a week presented to the emergency department (ED) with severe dizziness and vomiting for 2 h. She did not have a headache, unsteady gait, focal limb weakness, blurred vision or sensory deficiency. Her temperature was 36.9°C (98.4°F), pulse rate 81 beats/min, respiratory rate 16 breaths/min, and blood pressure 175/78 mm Hg. Physical examination and neurological signs were unremarkable. Laboratory tests showed haematocrit 33.4%, serum creatinine 5.1 mg/dl, sodium 134 mEq/l, potassium 3.7 mEq/l and glucose 154 mg/dl. The clinical impression was dizziness and she was observed in the ED. Four hours later, altered consciousness with lethargy was noted. The Glascow Coma Scale was E2V3M5. There was no focal neurological deficiency. Her family denied that she had taken any hypnotic agents recently. A non-contrast CT scan of the head was performed...