Rhabdomyolysis Associated with Severe Levodopa-Induced Dyskinesia in Parkinson's Disease: A Report of Two Cases and Literature Review. Issue 1 (30th September 2021)

• Record Type: Journal Article
• Authors: Pitakpatapee, Yuvadee; Srikajon, Jindapa; Sangpeamsook, Tanita; Srivanitchapoom, Prachaya
• Is Part Of: Tremor and other hyperkinetic movements. Volume 11:Issue 1(2021)
• Publication Date: 2021-09-30
• Subjects: Dyskinesia -- Dyskinesia hyperpyrexia -- Hyperkinetic emergencies -- Parkinson's disease; Tremor -- Periodicals; Hyperkinesia -- Periodicals; 616.8
• DOI: 10.5334/tohm.641
• Languages: English
• ISSNs: 2160-8288

Abstract

Background: Rhabdomyolysis associated with levodopa-induced dyskinesia (Rhab-LID) is an extremely rare, life-threatening, but treatable condition in patients with Parkinson's disease (PD). Case report: We reported two cases of Rhab-LID. The first case was a 64-year-old man presenting with severe generalized dyskinesia with elevated serum creatine kinase (CK) level. He was diagnosed with Rhab-LID owing to unpredictable gastric emptying time. The second case was a 61-year-old woman presenting with fever, myalgia, and disabling dyskinesia with elevated serum CK. She was diagnosed with dyskinesia-hyperpyrexia syndrome (DHS) due to increasing dosage of ropinirole and infection. Dopaminergic medications were stopped, and supportive care was initiated in both cases with excellent outcomes. Conclusion: Early recognition, stopping dopaminergic medications, treating precipitating causes, and proper supportive treatment can provide favorable outcomes.