Reversible craniocervical dystonia associated with levofloxacin

摘要

BackgroundDystonia is a hyperkinetic movement disorder related to dysfunction of inhibitory basal ganglia and cortical circuits. GABA is the major inhibitory neurotransmitter in the central nervous system. Quinolones can rarely produce serious neurologic effects, which have been attributed to impaired inhibition through GABA antagonism. We report a case of reversible craniocervical dystonia associated with oral levofloxacin. Case presentationA 62-year-old man on hemodialysis presented with craniocervical dystonia 3?days after initiation of levofloxacin 500?mg. twice daily. Levofloxacin was discontinued. Seven days later the abnormal movements completely disappeared and did not recur in the following 3?months. ConclusionLevofloxacin should be considered as a rare but potentially reversible trigger of craniocervical dystonia. Older age, renal impairment and high doses of the drug might be risk factors.