Does Levofloxacin Improve Parkinsonian Features or Is the Improvement Only Coincidental?

Ayoubi, Nabil El

doi:10.1097/wnf.0000000000000182

Cited by 2 publications

(3 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Interestingly, some case reports of FQN show improvement in Parkinson’s disease symptoms. El Ayoubi and Sawaya wrote a case of an elderly male with Parkinson’s disease and upper respiratory tract infection for which levofloxacin was prescribed [ 93 ]. Two days later, his bradykinesia and gait instability were significantly improved.…”

Section: Discussionmentioning

confidence: 99%

Fluoroquinolone-Associated Movement Disorder: A Literature Review

Rissardo

Caprara

2023

Medicines

View full text Add to dashboard Cite

Background: Fluoroquinolones (FQNs) are related to several central nervous system side effects. This review aims to evaluate the clinical-epidemiological profile, pathophysiological mechanisms, and management of FQNs-associated movement disorders (MDs). Methods: Two reviewers identified and assessed relevant reports in six databases without language restriction between 1988 and 2022. Results: A total of 45 reports containing 51 cases who developed MDs secondary to FQNs were reported. The MDs included 25 myoclonus, 13 dyskinesias, 7 dystonias, 2 cerebellar syndromes, 1 ataxia, 1 tic, and 2 undefined cases. The FQNs reported were ciprofloxacin, ofloxacin, gatifloxacin, moxifloxacin, levofloxacin, gemifloxacin, and pefloxacin. The mean and median age were 64.54 (SD: 15.45) and 67 years (range: 25–87 years). The predominant sex was male (54.16%). The mean and median time of MD onset were 6.02 (SD: 10.87) and 3 days (range: 1–68 days). The mean and median recovery time after MD treatment was 5.71 (SD: 9.01) and 3 days (range: 1–56 days). A complete recovery was achieved within one week of drug withdrawal in 80.95% of the patients. Overall, 95.83% of the individuals fully recovered after management. Conclusions: Future cases need to describe the long-term follow-up of the individuals. Additionally, FQN-induced myoclonus should include electrodiagnostic studies.

show abstract

Section: Discussionmentioning

confidence: 99%

Fluoroquinolone-Associated Movement Disorder: A Literature Review

Rissardo

Caprara

2023

Medicines

View full text Add to dashboard Cite

show abstract

“…We were only able to find a single published case report of parkinsonian symptom improvement after levofloxacin administration. El Ayoubi et al reported a patient with PD who repeatedly showed improvement of bradykinesia and gait instability, 2 days after levofloxacin, with symptoms returning to baseline level 2 days after discontinuation of levofloxacin [2] . Since drug interaction was less likely, the authors hypothesized that the direct central nervous system (CNS) effect of levofloxacin, including its anti-GABAergic effect, which is known to be related to its CNS side effects, may have contributed to the patient’s symptomatic improvement [2] .…”

Section: Discussionmentioning

confidence: 99%

“…El Ayoubi et al reported a patient with PD who repeatedly showed improvement of bradykinesia and gait instability, 2 days after levofloxacin, with symptoms returning to baseline level 2 days after discontinuation of levofloxacin [2] . Since drug interaction was less likely, the authors hypothesized that the direct central nervous system (CNS) effect of levofloxacin, including its anti-GABAergic effect, which is known to be related to its CNS side effects, may have contributed to the patient’s symptomatic improvement [2] . This mechanism of action has also been considered in other reports of levofloxacin administration for improvement of neuropsychiatric conditions, such as apathy [3] .…”

Section: Discussionmentioning

confidence: 99%