Published online February 1, 2007
PEDIATRICS Vol. 119 No. 2 February 2007, pp. e519-e522 (doi:10.1542/peds.2006-1609)
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EXPERIENCE & REASON

Gabapentin Successfully Manages Chronic Unexplained Irritability in Children With Severe Neurologic Impairment

Julie M. Hauer, MDa,b, Beverly S. Wical, MDb,c and Lawrence Charnas, MD, PhDc

c Division of Pediatric Clinical Neuroscience
a Department of Pediatrics, University of Minnesota, Minneapolis, Minnesota
b Gillette Children's Specialty Healthcare, St Paul, Minnesota

ABSTRACT

Neurologically impaired children have an increased frequency of recurrent pain and irritability that persist in some despite comprehensive evaluation and management of possible pain sources. We hypothesized that visceral hyperalgesia was a source of chronic unexplained irritability and report the outcome of gabapentin treatment in 9 severely neurologically impaired children. Caregivers reported marked improvement after treatment ranging from 3 months to 3 years. Nystagmus in 1 child was the only noted adverse effect. Visceral hyperalgesia may be a source of unexplained irritability in the neurologically impaired child. Symptoms may improve with gabapentin treatment.

Key Words: irritability • pain • visceral hyperalgesia • gabapentin • neurological impairment

Abbreviations: GER, gastroesophageal reflux

Accepted Sep 13, 2006.