Pregabalin-induced Positive Myoclonus Mimicking a Stroke: A Case Report

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Pregabalin is often prescribed to relieve neuropathic pain and is largely tolerated very well. Myoclonus as an adverse effect of pregabalin use is an infrequent occurrence that may go unrecognised. This case describes a 62-year-old female patient who developed myoclonus shortly after dose escalation of pregabalin from 75 mg twice daily to 150 mg twice daily, raising concerns about an acute underlying neurological condition. An extensive evaluation revealed no evidence of a structural, metabolic, infectious, epileptic, endocrine or toxic cause. The close temporal relationship between the onset of positive myoclonus and the use of pregabalin, along with the return of the patient to her baseline physical and neurological state following discontinuation of the drug, supported the diagnosis of pregabalin-induced positive myoclonus. Physicians should perform a thorough medication review for the identification of potential adverse drug reactions, exclude other possible diagnoses, and withdraw the use of pregabalin in order to ensure that the patient has a complete return to a normal neurological state.