title: Gentamicin-induced myoclonus: a case report and literature review of antibiotics-induced myoclonus.
abstract: BACKGROUND
  Drug-induced myoclonus is a diagnosis of exclusion. Various drugs have been reported to induce myoclonus. Antibiotic-induced myoclonus (AIM) is very rare. We describe a case of multifocal myoclonus secondary to gentamicin toxicity and review the literature of AIM.
  
  
  METHODS
  A 59-year-old woman with end-stage renal disease developed generalized multifocal myoclonus within 1 hour after receiving only 1 supratherapeutic dose of gentamicin for a potential hemodialysis catheter infection. Myoclonus was completely resolved after 2 sessions of hemodialysis. We identified 22 patients of AIM in the literature. The median age of patients was 63 years. More than half of patients (12/22, 55%) had underlying chronic kidney disease. Cephalosporins were the most common drug class associated with AIM (12/22 patients; 55%). About two third of patients (15/22, 68%) received overdoses of antibiotics. Fifteen patients (71%) completely recovered after discontinuing or decreasing the dose of antibiotics. Five patients (24%) died of underlying medical conditions or of unknown etiology. Only 1 had persistent myoclonus. The potential mechanisms of AIM are discussed.
  
  
  CONCLUSIONS
  AIM, although rare, should be considered as a potential cause of multifocal myoclonus in patients with advanced age or renal insufficiency. The prognosis of AIM appears favorable, with several cases resolving after withdrawal of the antibiotic.
authors.affiliation: Department of Neurology, SUNY Downstate Medical Center, Brooklyn, NY 11203, USA.
authors.forename: Harini
authors.initials: H
authors.lastname: Sarva
authors.forename: Kessarin
authors.initials: K
authors.lastname: Panichpisal
mesh_terms: D000900:Anti-Bacterial Agents / Q000009:adverse effects*; D002511:Cephalosporins / Q000009:adverse effects; D005260:Female; D005839:Gentamicins / Q000009:adverse effects*; D006801:Humans; D007676:Kidney Failure, Chronic / Q000139:chemically induced; D008875:Middle Aged; D009207:Myoclonus / Q000139:chemically induced*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D005839:Gentamicins