There is recent interest in gabapentin (GBP) in the management of dystonia. A retrospective study indicated usefulness in dystonic CP. We therefore decided to do a short term open label prospective study in dystonia.

Methods: After ethics committee approval and informed consent, the study was conducted in patients with significant dystonia seen at a tertairy pediatric neurology clinic in Mumbai, India.  Clinical severity of the dystonia was assessed based on the Burke –Fahn-Marsden Dystonia Rating Scale  (BFMDRS) and functional ability was assessed by the  Gross Motor Function Measure (GMFMS). Both were done at recruitment and after 3 months of treatment with GBP. GBP dosage was titrated upto 30mg/kg/day or to maximally tolerated dose within 1-2 week in all patients.

Results: 34 patients were enrolled (22 males). Mean age was 5.75 yrs. 29 were dystonic cerebral palsies. Mean follow up duration was 4.2 months. The mean GMFM score at study entry was 32.06 which increased significantly to 38.14 at stusy termination ( z -4.1714, p< 0.001).  The mean BFMDS score at entry 61.76  significantly decreased to 58.76  (z – 2.5858, p < 0.05) at termination. Subjective improvement was noted by 13/15 caregivers in terms of improved sleep, decreased irritability, decreased tightness, decreased involuntary contractions. Side effects noted were constipation(3),somnolence (1) and increased falls(1).

Conclusion : Gabapentin reduces dystonia severity with improvement in quality of life. A randomised controlled trials would be needed for confirmation of these preliminary findings.