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  3. Vol. 18 No. 3 (2024): summer
  4. Case Report

Vol. 18 No. 3 (2024)

May 2024

Levofloxacin-Induced Oromandibular Dystonia in a 9-Year-Old Patient

  • Mohammadreza Ghazavi
  • zahra allameh

Iranian Journal of Child Neurology, Vol. 18 No. 3 (2024), 22 May 2024 , Page 151-157
https://doi.org/10.22037/ijcn.v18i3.18054 Published: 2024-05-22

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Abstract

Extrapyramidal symptoms (EPS) that include akathisia, dystonia, pseudoparkinsonism, and dyskinesia are abnormal movements commonly induced by antipsychotic medications. These symptoms are also associated with specific non-antipsychotic agents. This case report describes a case of a 9-year-old boy on antibiotics treatment that developed EPS.
A 9-year-old boy presented to the emergency department of Imam Hossein Children›s Hospital with chief complaints of trismus, difficulty speaking, and tongue protrusion. One week before these presentations, he had been prescribed Tavanex® (levofloxacin) and clindamycin. His symptoms improved after the withdrawal of antibiotics and administering Biperiden, and he was discharged in good condition. On a follow-up visit one week after discharge, no remaining symptoms were present, and he was in good condition.
Based on the questions in the Naranjo criteria, levofloxacin receives a score of 7 and is a probable cause of adverse drug reaction (ADR). Clindamycin, with a score of 6, is also a probable cause for this adverse drug reaction, but clinical judgment was in favor of levofloxacin as the culprit.
Clinicians should be aware of the potential EPS of levofloxacin at standard doses. Effective management of adverse events is necessary to ensure patient safety and optimal outcomes

Keywords:
  • Levofloxacin
  • oromandibular dystonia
  • pediatric
  • pdf

How to Cite

Ghazavi, M., & allameh, zahra. (2024). Levofloxacin-Induced Oromandibular Dystonia in a 9-Year-Old Patient. Iranian Journal of Child Neurology, 18(3), 151–157. https://doi.org/10.22037/ijcn.v18i3.18054
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References

Tamra, Jean, Courey. Detection, Prevention, and Management of Extrapyramidal Symptoms. Journal for Nurse Practitioners. 2007;3(7):464-9.

Blair DT, Dauner A. Extrapyramidal symptoms are serious side-effects of antipsychotic and other drugs. The Nurse practitioner. 1992;17(11):56, 62-4, 7.

Burgyone K, Aduri K, Ananth J, Parameswaran S. The use of antiparkinsonian agents in the management of drug-induced extrapyramidal symptoms. Current pharmaceutical design. 2004;10(18):2239-48.

Shireen E. Experimental treatment of antipsychotic-induced movement disorders. Journal of experimental pharmacology. 2016;8:1-10.

dyskinesia. Rmdeseat. Available at: www.medicalnewstoday.com Accessed July 18, 2006.

Bailey KP. Do atypical antipsychotic agents cause tardive dyskinesia? Journal of psychosocial nursing and mental health services. 2004;42(10):14-9.

Davis R, Bryson HM. Levofloxacin. A review of its antibacterial activity, pharmacokinetics and therapeutic efficacy. Drugs. 1994;47(4):677-700.

MacLeod W. Case report: severe neurologic reaction to ciprofloxacin. Canadian family physician Medecin de famille canadien. 2001;47:553-5.

Lee CH, Cheung RT, Chan TM. Ciprofloxacin-induced oral facial dyskinesia in a patient with normal liver and renal function. Hospital medicine (London, England : 1998). 2000;61(2):142-3.

Simpson KJ, Brodie MJ. Convulsions related to enoxacin. Lancet (London, England). 1985;2(8447):161.

Slavich IL, Gleffe RF, Haas EJ. Grand mal epileptic seizures during ciprofloxacin therapy. Jama. 1989;261(4):558-9.

Thomas RJ, Reagan DR. Association of a Tourette-like syndrome with ofloxacin. The Annals of pharmacotherapy. 1996;30(2):138-41.

Singh J, Agarwal AK, Sudrania SP. Extrapyramidal syndrome following ciprofloxacin treatment. Indian pediatrics. 1994;31(5):608-9.

Akahane K, Tsutomi Y, Kimura Y, Kitano Y. Levofloxacin, an optical isomer of ofloxacin, has attenuated epileptogenic activity in mice and inhibitory potency in GABA receptor binding. Chemotherapy. 1994;40(6):412-7.

Slobodin G, Elias N, Zaygraikin N, Sheikh-Ahmad M, Sabetay S, Weller B, et al. Levofloxacin-induced delirium. Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology. 2009;30(2):159-61.

Zhang LR, Wang YM, Chen BY, Cheng NN. Neurotoxicity and toxicokinetics of norfloxacin in conscious rats. Acta pharmacologica Sinica. 2003;24(6):605-9.

Ball P, Mandell L, Patou G, Dankner W, Tillotson G. A new respiratory fluoroquinolone, oral gemifloxacin: a safety profile in context. International journal of antimicrobial agents. 2004;23(5):421-9.

Pastor P, Moitinho E, Elizalde I, Cirera I, Tolosa E. Reversible oral-facial dyskinesia in a patient receiving ciprofloxacin hydrochloride. Journal of neurology. 1996;243(8):616-7.

De Bleecker JL, Vervaet VL, De Sarro A. Reversible orofacial dyskinesia after ofloxacin treatment. Movement disorders : official journal of the Movement Disorder Society. 2004;19(6):731-2.

Blomer R, Bruch K, Krauss H, Wacheck W. Safety of ofloxacin--adverse drug reactions reported during phase-II studies in Europe and in Japan. Infection. 1986;14 Suppl 4:S332-4.

Bellon A, Perez-Garcia G, Coverdale JH, Chacko RC. Seizures associated with levofloxacin: case presentation and literature review. European journal of clinical pharmacology. 2009;65(10):959-62.

Jungst G, Mohr R. Side effects of ofloxacin in clinical trials and in postmarketing surveillance. Drugs. 1987;34 Suppl 1:144-9.

Grill MF, Maganti RK. Neurotoxic effects associated with antibiotic use: management considerations. British journal of clinical pharmacology. 2011;72(3):381-93.

Fennig S, Mauas L. Ofloxacin-induced delirium. The Journal of clinical psychiatry. 1992;53(4):137-8.

Fernandez-Torre JL. Levofloxacin-induced delirium: Diagnostic considerations. Clinical neurology and neurosurgery. 2006;108(6):614.

Lowe MN, Lamb HM. Gemifloxacin. Drugs. 2000;59(5):1137-47; discussion 48.

Akahane K, Sekiguchi M, Une T, Osada Y. Structure-epileptogenicity relationship of quinolones with special reference to their interaction with gamma-aminobutyric acid receptor sites. Antimicrobial agents and chemotherapy. 1989;33(10):1704-8.

Tsuji A, Sato H, Kume Y, Tamai I, Okezaki E, Nagata O, et al. Inhibitory effects of quinolone antibacterial agents on gamma-aminobutyric acid binding to receptor sites in rat brain membranes. Antimicrobial agents and chemotherapy. 1988;32(2):190-4.

Kiangkitiwan B, Doppalapudi A, Fonder M, Solberg K, Bohner B. Levofloxacin-induced delirium with psychotic features. General hospital psychiatry. 2008;30(4):381-3.

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