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Abstract
Gabapentin is frequently prescribed for neuropathic pain and restless leg syndrome, particularly in patients with end-stage renal disease (ESRD). While generally well tolerated, rare adverse effects such as myoclonus can occur, particularly in those with impaired renal clearance. We report the case of a 72-yearold female with ESRD on maintenance hemodialysis who developed generalized
myoclonus following a recent increase in her gabapentin dose. Neurological investigations ruled out structural or infectious causes. Her symptoms resolved completely after discontinuation of gabapentin and supportive care. This case highlights the importance of cautious dosing of renally excreted drugs like gabapentin and monitoring for neurotoxic side effects in dialysis patients.