Donepezil-induced cervical dystonia in Alzheimer's disease: a case report and literature review of dystonia due to cholinesterase inhibitors.
We herein report an 81-year-old woman with Alzheimer's disease (AD) in who donepezil, a cholinesterase inhibitor (ChEI), caused cervical dystonia. The patient had a two-year history of progressive memory disturbance fulfilling the NINCDS-ADRDA criteria for probable AD. Mini-Mental State Examination score was 19/30. The remaining examination was normal. After a single administration of donepezil (5 mg/day) for 10 months, she complained of dropped head. Neurological examination and electrophysiological studies supported a diagnosis of cervical dystonia. Antecollis disappeared completely at 6 weeks after cessation of donepezil. Dystonic posture can occur at various timings of ChEI use. Physicians should pay more attention to rapidly progressive cervical dystonia in ChEI-treated AD patients.
Department of Neurology, Toho University Omori Medical Center, Japan.
Ken
K
Ikeda
Masaru
M
Yanagihashi
Masahiro
M
Sawada
Sayori
S
Hanashiro
Kiyokazu
K
Kawabe
Yasuo
Y
Iwasaki
D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use; D000077265:Donepezil; D004421:Dystonia / Q000139:chemically induced* / Q000175:diagnosis / Q000503:physiopathology; D005260:Female; D006801:Humans; D007189:Indans / Q000009:adverse effects* / Q000627:therapeutic use; D010880:Piperidines / Q000009:adverse effects* / Q000627:therapeutic use; D004856:Postural Balance / Q000187:drug effects*
D002800:Cholinesterase Inhibitors; D007189:Indans; D010880:Piperidines; D000077265:Donepezil