title: Orofacial dyskinesia after moxifloxacin treatment--a case with normal hepatorenal function and review of literature.
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.
authors.affiliation: Department of Neurology, Yale University School of Medicine, New Haven, CT 06520, USA. shivam.mittal@yale.edu
authors.forename: Shivam Om
authors.initials: SO
authors.lastname: Mittal
authors.forename: Duarte Goncalves
authors.initials: DG
authors.lastname: Machado
authors.forename: Bahman
authors.initials: B
authors.lastname: Jabbari
mesh_terms: D000890:Anti-Infective Agents / Q000009:adverse effects*; D001372:Aza Compounds / Q000009:adverse effects*; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D024841:Fluoroquinolones; D006801:Humans; D007677:Kidney Function Tests / Q000379:methods / Q000639:trends; D008111:Liver Function Tests / Q000379:methods / Q000639:trends; D008875:Middle Aged; D009069:Movement Disorders / Q000175:diagnosis / Q000503:physiopathology; D000077266:Moxifloxacin; D011804:Quinolines / Q000009:adverse effects*; D016896:Treatment Outcome
chemical_list: D000890:Anti-Infective Agents; D001372:Aza Compounds; D024841:Fluoroquinolones; D011804:Quinolines; D000077266:Moxifloxacin