OBJECTIVE: To describe a child who developed a skin reaction during gabapentin 
therapy and discuss how we evaluated the probability of an adverse drug 
reaction.
CASE SUMMARY: An 8-year-old boy with a neurodegenerative disease of unknown 
origin and an epilepsy disorder developed an urticarial rash and irritability 10 
and 4 days, respectively, after the start of gabapentin 20 mg/kg 3 times a day 
for epilepsy control. Otherwise, the child was well; no changes in other 
medication or diet had recently been made. After gabapentin discontinuation and 
administration of one dose of methylprednisolone 10 mg/kg intravenously and 
diphenhydramine 1 mg/kg every 4 hours via gastric tube, the rash disappeared 
over 3 weeks.
DISCUSSION: In contrast to other antiepileptic drugs, skin reactions to 
gabapentin are considered uncommon. In adults, reported prevalence of rash 
possibly related to gabapentin range from 1% to 10%. A postmarketing 
surveillance study reported gabapentin treatment failure as a consequence of 
rash in 0.4% of 3000 patients. The product monograph does not mention rash in 
children. In our patient, assessment using an objective causality scale revealed 
that the rash was probably caused by gabapentin.
CONCLUSIONS: This case, and limited literature data, suggest that gabapentin may 
cause rash that is severe enough to necessitate discontinuation in a small 
percentage of children. Further research is needed to determine the actual 
incidence and severity of gabapentin-related rash in this population.