pregabalin and Paraplegia

Cross-sectional study.. Sleep disturbances are frequently reported by individuals with spinal cord injury (SCI) and are associated both with poor quality of life and reduced ability to participate in rehabilitation and daily life activities.. This study investigated sleep quality based on self-reports and actigraphy in individuals with SCI as compared to able-bodied. We also explored the relationship between sleep quality, physical activity, and neuropathic pain.. Institute Guttmann, Neurorehabilitation Hospital, Badalona, Barcelona, Spain.. Fourteen SCI patients (12 males, 43.10 ± 10.59 y.o.) and 10 healthy individuals (7 males, mean age 46.21 ± 12.58 y.o.) were enrolled in the study. Participants wore wrist actigraphs for 7 consecutive days to characterize their sleep-wake cycle, rest-activity circadian rhythm and physical activity. Sleep quality, chronotype, daytime sleepiness, neuropathic pain severity and interference were assessed based on questionnaires.. SCI individuals reported poorer sleep quality compared to healthy individuals. Actigraphy-based sleep measurements revealed that patients woke up later, spent more time in bed and slept longer compared to the healthy controls but did not differ significantly in the estimated sleep efficacy and number of awakenings from the able-bodied controls. In individuals with SCI greater physical activity predicted higher sleep efficacy and less awakening episodes as well as shorter sleep latency and lower sleep disturbance.. The actigraphy-based sleep estimates indicate that patients with SCI spent more time in bed and slept longer but their sleep efficacy was similar to able-bodied controls. Maintaining regular physical activity could improve pain control and sleep quality.

Topics: Actigraphy; Adult; Analgesics; Benzodiazepines; Case-Control Studies; Exercise; Female; Gabapentin; Humans; Male; Middle Aged; Neuralgia; Pain Measurement; Paraplegia; Pregabalin; Sleep; Sleep Latency; Sleep Wake Disorders; Sleepiness; Spinal Cord Injuries

Case report.. To report a case of paraplegia with limb edema caused by pregabalin.. Turkish Armed Forces Rehabilitation Center, Ankara, Turkey.. A 40-year-old male patient with T11 paraplegia had the complaint of swelling in both the lower limbs. He had been given pregabalin because of the neuropathic pain in both the lower limbs. At 10 months, the patient has experienced edema in lower limbs. There was severe edema in both legs, ankles and feet, more evident on the left. Venous Doppler ultrasound was normal on both sides. Blood tests for possible etiologies were normal. No other etiology could be found. The edema was considered to be caused by pregabalin and the medicine was ceased gradually. The edema resolved completely in 2 weeks.. Pregabalin, which is one of medications used for neuropathic pain, might cause limb edema, that is, a condition needs differential diagnosis. This is particularly important for patients with spinal cord injuries (SCIs). Such adverse effect of pregabalin should be kept in mind as an etiology of limb edema in SCI management.

Topics: Adult; Analgesics; Edema; gamma-Aminobutyric Acid; Humans; Lower Extremity; Male; Neuralgia; Paraplegia; Pregabalin; Spinal Cord Injuries

To assess the effects of different doses and treatment durations of pregabalin and lamotrigine on the urodynamic parameters of an animal model of neurogenic detrusor overactivity (NDO).. Ninety rats were used; six as normal controls and the remaining 84 were divided as follows: Six "paraplegic controls," 6 "paraplegic-vehicle controls," and the remaining 72 divided into two equal groups. Group 1 was divided into six subgroups; pregabalin was given in doses of 10 mg/kg, 20 mg/kg, or 30 mg/kg for 1 or 2 weeks. Group 2 was similarly subdivided; lamotrigine was given in doses of 1.5 mg/kg, 3 mg/kg, or 6 mg/kg for 1 or 2 weeks.. All paraplegic controls developed NDO within 3 weeks from spinalization. Their baseline bladder pressure (BBP) 19 ± 4.4 cmH(2) O, detrusor pressure at maximum capacity (DPMaxC) 47.6 ± 4.3 cmH(2) O, bladder capacity (BC) 0.45 ± 0.1 ml, and frequency of detrusor overactivity (FDO) 3.7 ± 0.9/min. Both pregabalin and lamotrigine produced significant improvement. Urodynamic values in those treated with 20 mg pregabalin for 1 or 2 weeks were: BBP 11.7 ± 1.3 and 9 ± 0.2 cmH(2) O, BC 0.6 ± 0.1 and 0.7 ± 0.01 ml, DPMaxC 17.3 ± 4.0 and 23 ± 2.6 cmH(2) O, FDO 2.1 ± 0.2/min and 1.7 ± 0.1/min. Urodynamic values in those treated with 3 mg/kg lamotrigine for 1 or 2 weeks were: BBP 9.7 ± 2.2 and 8.6 ± 1.9 cmH(2) O, DPMaxC 17.2 ± 1.8 and 29 ± 1.2 cmH(2) O, BC 0.7 ± 0.1 and 0.8 ± 0.1 ml, FDO 1.9 ± 0.2/min and 1.9 ± 0.2/min (P < 0.001).. Pregabalin and lamotrigine may represent novel alternative treatments of NDO. Clinical trials remain to be performed.

Topics: Animals; Anticonvulsants; Disease Models, Animal; Dose-Response Relationship, Drug; Female; gamma-Aminobutyric Acid; Lamotrigine; Paraplegia; Pregabalin; Pressure; Rats; Rats, Sprague-Dawley; Time Factors; Triazines; Urinary Bladder; Urinary Bladder, Neurogenic; Urinary Bladder, Overactive; Urination; Urodynamics