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Effective treatment of orthostatic tremor with gabapentin. Evidente VG, Adler CH, Caviness JN, Gwinn KA Parkinson's Disease and Movement Disorders Center,
Mayo Clinic Scottsdale, Arizona 85259, USA.
We report seven patients with orthostatic tremor (OT) who were successfully treated with theanticonvulsant gabapentin. Five of the patients had been previously tried on clonazepam, the mostcommonly used drug for OT, four without any benefit. The degree of improvement perceived by thepatients with gabapentin varied from 60-80% (mean 73%). The effective dose of gabapentin ranged from300-1800 mg/day (mean 1030 mg/day). The side effects were generally mild, transient, and dose-related.Duration of response has so far ranged from 2-22 months (mean 11 months) with all patients still currentlybenefiting from gabapentin. We conclude that gabapentin may be an effective treatment for OT. Furthertrials are indicated. PMID: 9756154, UI: 98427585
Electroencephalogr Clin Neurophysiol 1998 Aug;109(4):321-30 Pharmacological control of facilitatoryI-wave interaction in the human motor cortex. A paired transcranial magnetic stimulation study. ZiemannU, Tergau F, Wischer S, Hildebrandt J, Paulus W Department of Clinical Neurophysiology, University ofGottingen, Germany. email@example.com A novel paired transcranial magnetic stimulation (TMS)paradigm with a suprathreshold first and a subthreshold second stimulus was used in healthy volunteersto investigate the acute effects of a single oral dose of various CNS-active drugs on short-interval motorevoked potential (MEP) facilitation. MEPs were recorded from the relaxed abductor digiti muscle. Threepeaks of MEP facilitation were consistently observed at interstimulus intervals of 1.1-1.5 ms, 2.3-2.7 ms,and 3.9-4.5 ms. The size of these MEP peaks was transiently suppressed by drugs which enhancegamma-aminobutyric acid (GABA) function in the neocortex (lorazepam, vigabatrin, phenobarbital,ethanol), while the GABA-B receptor agonist baclofen, anti-glutamate drugs (gabapentin, memantine), andsodium channel blockers (carbamazepine, lamotrigine) had no effect. The interstimulus intervals effectivefor the production of the MEP peaks remained unaffected by all drugs. The MEP peaks are thought to bedue to a facilitatory interaction of I-(indirect) waves in the motor cortex. Therefore, the present resultsindicate that the production of I-waves is primarily controlled by GABA related neuronal circuits. Thepotential relevance of this non-invasive paired TMS protocol for the investigation of I-waves in patientswith neurological disease will be discussed. Publication Types: * Clinical trial PMID: 9751295, UI: 98421915
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Mov Disord 1998 Sep;13(5):829-31