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Gabapentin can improve postural stability and quality of life in primary orthostatic tremor

Authors

  • Julian P. Rodrigues MD,

    Corresponding author
    1. Australian Neuromuscular Research Institute, Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, WA, Australia
    • Centre for Neuromuscular and Neurological Disorders, Level 4 ‘A’ Block, QEII Medical Centre, Nedlands, Western Australia 6009
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  • Dylan J. Edwards PhD,

    1. Australian Neuromuscular Research Institute, Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, WA, Australia
    2. School of Biomedical and Sports Science, Edith Cowan University, Perth, WA, Australia
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  • Susan E. Walters Ba Appl Sci Physio,

    1. Australian Neuromuscular Research Institute, Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, WA, Australia
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  • Michelle L. Byrnes PhD,

    1. Australian Neuromuscular Research Institute, Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, WA, Australia
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  • Gary Thickbroom PhD,

    1. Australian Neuromuscular Research Institute, Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, WA, Australia
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  • Rick Stell MD,

    1. Australian Neuromuscular Research Institute, Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, WA, Australia
    2. Department of Neurology and Neurophysiology, Sir Charles Gairdner Hospital, Perth, WA, Australia
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  • Frank L. Mastaglia MD

    1. Australian Neuromuscular Research Institute, Centre for Neuromuscular and Neurological Disorders, University of Western Australia, Perth, WA, Australia
    2. Department of Neurology and Neurophysiology, Sir Charles Gairdner Hospital, Perth, WA, Australia
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Abstract

Primary orthostatic tremor (OT) is characterized by leg tremor and instability on standing. High frequency (13–18 Hz) tremor bursting is present in leg muscles during stance, and posturography has shown greater than normal sway. We report on an open-label add-on study of gabapentin in 6 patients with OT. Six patients were studied with surface electromyography, force platform posturography, and a modified Parkinson's disease questionnaire (PDQ-39) quality of life (QOL) scale before and during treatment with gabapentin 300 mg t.d.s. If on other medications for OT, these were continued unchanged. Of the 6 patients, 4 reported a subjective benefit of 50 to 75% with gabapentin, 3 of whom showed reduced tremor amplitude and postural sway of up to 70%. Dynamic balance improved in all 3 patients who completed the protocol. QOL data from 5 patients showed improvement in all cases. No adverse effects were noted. Gabapentin may improve tremor, stability, and QOL in patients with OT, and symptomatic response correlated with a reduction in tremor amplitude and postural sway. The findings confirm previous reports of symptomatic benefit with gabapentin and provide justification for larger controlled clinical trials. Further work is required to establish the optimal dosage and to validate the methods used to quantify the response to treatment. © 2005 Movement Disorder Society

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