Orofacial dyskinesia after moxifloxacin treatment--a case with normal hepatorenal function and review of literature

Clin Neuropharmacol. 2012 Nov-Dec;35(6):292-4. doi: 10.1097/WNF.0b013e31826ba0eb.

Abstract

Background: Orofacial dyskinesia is rarely reported with antibiotics. Among antibiotics, third-generation fluoroquinolones are known to cause movement disorders. We report the first patient who developed orofacial dyskinesia after taking a fourth-generation fluoroquinolone, namely, moxifloxacin.

Methods: The patient is a 58-year-old woman who was treated with moxifloxacin for acute bronchitis. She developed orofacial dyskinesia involving the tongue, lips, and facial muscles after treatment.

Results: Discontinuation of moxifloxacin and treatment with clonidine resulted in significant reduction of orofacial dyskinesia over the period of 8 to 12 weeks. A review of literature shows reports of a variety of involuntary movements with third-generation fluoroquinolones, mostly manifesting in patients with impaired renal and kidney function.

Conclusions: The fourth-generation fluoroquinolone moxifloxacin can cause orofacial dyskinesia like third-generation fluoroquinolone antibiotics and in a patient with normal renal and liver function.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Anti-Infective Agents / adverse effects*
  • Aza Compounds / adverse effects*
  • Dyskinesia, Drug-Induced / diagnosis*
  • Dyskinesia, Drug-Induced / physiopathology
  • Female
  • Fluoroquinolones
  • Humans
  • Kidney Function Tests* / methods
  • Kidney Function Tests* / trends
  • Liver Function Tests* / methods
  • Liver Function Tests* / trends
  • Middle Aged
  • Movement Disorders / diagnosis
  • Movement Disorders / physiopathology
  • Moxifloxacin
  • Quinolines / adverse effects*
  • Treatment Outcome

Substances

  • Anti-Infective Agents
  • Aza Compounds
  • Fluoroquinolones
  • Quinolines
  • Moxifloxacin