Effects of Gabapentin (Neurontin(R)) in the Post-Stroke Reflex Sympathetic Dystrophy

ABSTRACT

OBJECTIVE: To evaluate effects of gabapentin in post-stroke reflex sympathetic dystrophy (RSD). METHOD: To 20 RSD patients after stroke, gabapentin was administrated. We started medication with 300 mg per day and increased dosage by 300 mg per two days up to maximum 900~1,200 mg. We evaluated RSD symptom severities with hand pain, hand swelling and shoulder pain before gabapentin administration. Severity of each symptoms was graded and scored (0 no pain/swelling, 1 mild, 2 moderate, 3 severe). Severities of RSD symptoms were reevaluated on every dose increasing and on 1 week, 2 weeks and 4 weeks later after administrating maximum dosage. We defined as no effect group didn't have any improvement in symptom severity score in comparison with baseline score. Medications other than gabapentin were administrated in no effect group. RESULTS: Among 19 subjects whom we could follow-up, 4 subjects were defined as no effect group. 15 (78.9%) subjects showed improvement in symptom severity score. Statistically significant symptom improvements were observed after 4 weeks in comparison with baseline in hand pain and shoulder pain (p=0.000). From gabapentin 300~600 mg dosage, hand and shoulder pain showed significant pain decrease. Improvement of hand edema was observed after 4 weeks, but it was statistically insignificant. CONCLUSION: We conclude the gabapentin is effective for RSD pain, however further control study is required.