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Various toxicities: case report A 57-year-old man developed somnolence and sexual dysfunction during treatment with gabapentin; and developed slowed cognition, drowsiness and difficulty with sexual intercourse during treatment with pregabalin for meralgia paresthetica [not all routes and dosages stated; durations of treatment to reactions onset not stated]. The man presented with a 6-year history of painful numbness and burning along the lateral portion of his right thigh. He initially received treatment with oral gabapentin 600mg four times per day. Consequently, pain decreased; however, he experienced gabapentin related side effects of intolerable somnolence and sexual dysfunction. Additionally, he received oxycodone/paracetamol [oxycodone/acetaminophen]concomitantly. Considering his condition as meralgia paresthetica, his neurologist referred him for a diagnostic ultrasound-guided right lateral femoral cutaneous nerve (LFCN) block. The man’s treatment was changed from gabapentin to pregabalin due to the side effects with gabapentin. Despite good pain relief with pregabalin, he experienced unwanted pregabalin side effects in the form of drowsiness, slowed cognition and difficulty with sexual intercourse. Non-interventional and interventional options including spinal cord stimulation, dorsal root ganglion stimulation and peripheral nerve stimulation (PNS) were considered. PNS was considered to be the best option because of the directed therapy to the specific nerve in question. His treatment with pregabalin was discontinued within 4 weeks of the implantation procedure. Subsequently, the resolution of slowed cognition, drowsiness, and sexual dysfunction was observed. Consequently, his quality of life improved, with improved ability to sit in chairs, better sleep, less irritable mood and less somnolence. Langford B, et al. Peripheral Nerve Stimulation: A New Treatment for Meralgia Paresthetica. Pain Medicine : 8 Nov 2020. Available from: URL: http://doi.org/10.1093/pm/ pnaa326 803519957

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Reactions 12 Dec 2020 No. 1834