Fluoroquinolone-Associated Movement Disorder: A Literature Review

Rissardo, Jamir Pitton; Caprara, Ana Letícia Fornari

doi:10.3390/medicines10060033

Cited by 6 publications

(7 citation statements)

References 92 publications

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“…Chau et al reported a patient with Creutzfeldt–Jakob disease-like syndrome induced by gabapentin toxicity, in which electrodiagnostic studies showed periodic sharp wave complexes [ 40 ]. A similar clinical manifestation with electrodiagnostic studies was already observed with amitriptyline [ 121 ] and fluoroquinolones [ 17 ].…”

Section: Discussionsupporting

confidence: 79%

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Gabapentin-Associated Movement Disorders: A Literature Review

Rissardo,

Medeiros Araujo de Matos,

Fornari Caprara

2023

Medicines

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Background: Gabapentin (GBP)-induced movement disorders (MDs) are under-recognized adverse drug reactions. They are commonly not discussed with patients, and their sudden occurrence can lead to misdiagnosis. This literature review aims to evaluate the clinical–epidemiological profile, pathological mechanisms, and management of GBP-associated MD. Methods: Two reviewers identified and assessed relevant reports in six databases without language restriction between 1990 and 2023. Results: A total of 99 reports of 204 individuals who developed a MD associated with GBP were identified. The MDs encountered were 135 myoclonus, 22 dyskinesias, 7 dystonia, 3 akathisia, 3 stutterings, 1 myokymia, and 1 parkinsonism. The mean and median ages were 54.54 (SD: 17.79) and 57 years (age range: 10–89), respectively. Subjects were predominantly male (53.57%). The mean and median doses of GBP when the MD occurred were 1324.66 (SD: 1117.66) and 1033 mg/daily (GBP dose range: 100–9600), respectively. The mean time from GBP-onset to GBP-associated MD was 4.58 weeks (SD: 8.08). The mean recovery time after MD treatment was 4.17 days (SD: 4.87). The MD management involved GBP discontinuation. A total of 82.5% of the individuals had a full recovery in the follow-up period. Conclusions: Myoclonus (GRADE A) and dyskinesia (GRADE C) were the most common movement disorders associated with GBP.

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Section: Discussionsupporting

confidence: 79%

“…Movement disorder onset was defined as the time from the GBP start until the development of the movement disorder. Movement disorder recovery was defined as the time from the first management, which could be the GBP discontinuation, until the full recovery of the abnormal movement [ 17 ].…”

Section: Methodsmentioning

confidence: 99%

Gabapentin-Associated Movement Disorders: A Literature Review

Rissardo,

Medeiros Araujo de Matos,

Fornari Caprara

2023

Medicines

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“…Therefore, myoclonus secondary to amantadine could be related to a serotonergic mechanism. A similar explanation has been hypothesized for other drug-induced myoclonus, such as lithium and fluoroquinolones [ 26 , 27 ]. Notably, these drugs share case presentation similarities regarding myoclonus and progressive cognitive impairment, known by some authors as Creutzfeldt–Jakob-like syndrome.…”

Section: Discussionsupporting

confidence: 63%

Myoclonus Secondary to Amantadine: Case Report and Literature Review

Rissardo

Caprara

2023

Clinics and Practice

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The usual adverse events of amantadine are dizziness, dry mouth, and peripheral edema. Postmarketing experience has revealed abnormal movements such as tremors, involuntary muscle contractions, and gait abnormalities. Herein, we report a case of an elderly male who presented with generalized twitching associated with amantadine. A 64-year-old male presenting with jerking movements within one day of onset was admitted. Sudden and involuntary distal lower and upper limb muscle twitching was observed. The subject presented subsequent brief movements when attempting to stand or hold arms antigravity. He was diagnosed with Parkinson’s disease three years ago. Eight days before the presentation to the emergency department, he consulted with his primary care physician, who prescribed amantadine to improve his motor symptoms. On the seventh day, he developed brisk abnormal movements. Laboratory exams, neuroimaging, and electroencephalogram were unremarkable. Amantadine was discontinued. After three days, the patient reported that his jerking movements had fully recovered. To the authors’ knowledge, 22 individuals with amantadine-associated myoclonus had already been reported in the literature. The pathophysiology of amantadine-induced myoclonus is probably related to serotoninergic pathways. Myoclonus secondary to amantadine was slightly more common in men. The population affected was elderly, with a mean and median age of 67.7 and 64 years.

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“…Movement disorders, such as tremors or muscle spasms, have been reported in some cases, although these occurrences are rare [61]. The exact mechanism by which fluoroquinolones may contribute to movement disorders or neuromuscular symptoms is not fully understood [62]. It's important to note that the occurrence of movement disorders with fluoroquinolones is infrequent, and the overall benefit of these antibiotics in treating bacterial infections usually outweighs the risk of such side effects [63].…”

Section: Fluoroquinolonesmentioning

confidence: 99%

A Literature Review of Movement Disorder Associated with Medications and Systemic Diseases

Pitton Rissardo,

Fornari Caprara

2024

Preprint

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Movement disorders can be associated with various drugs and systemic diseases, posing diagnostic challenges for clinicians. This review explores the spectrum of movement disorders associated with pharmacological agents and medical conditions. Drug-induced movement disorders encompass a broad range of conditions resulting from exposure to medications that affect several neurotransmitters. Neuroleptic medications can lead to tardive dyskinesia, characterized by involuntary, repetitive movements. Antipsychotics and antiemetics, including metoclopramide, may induce acute dystonic reactions. Other drugs, such as dopamine receptor-blocking agents, can contribute to drug-induced parkinsonism. Beyond medications, movement disorders can also arise secondary to systemic diseases. Metabolic disorders like Wilson's disease, characterized by copper accumulation, may manifest as chorea or dystonia. Inflammatory conditions such as rheumatoid arthritis and systemic lupus erythematosus can result in secondary movement disorders due to autoimmune-mediated processes affecting the central nervous system. Movement disorders linked to drugs or systemic diseases often necessitate a thorough clinical evaluation, including detailed medication histories and comprehensive systemic assessments. Neuroimaging, laboratory investigations, and, in some cases, cerebrospinal fluid analyses and electrodiagnostic studies help in establishing accurate diagnoses. Management involves addressing the underlying cause, modifying medications, and employing symptomatic treatments.

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Fluoroquinolone-Associated Movement Disorder: A Literature Review

Cited by 6 publications

References 92 publications

Gabapentin-Associated Movement Disorders: A Literature Review

Gabapentin-Associated Movement Disorders: A Literature Review

Myoclonus Secondary to Amantadine: Case Report and Literature Review

A Literature Review of Movement Disorder Associated with Medications and Systemic Diseases

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