title: A Case Report on Dyskinesia Following Rivastigmine Patch 13.3 mg/24 hours for Alzheimer's Disease: Perspective in the Movement Disorders Spectrum Following Use of Cholinesterase Inhibitors.
abstract: Current reports on movement disorder adverse effects of acetylcholinesterase inhibitors only include extrapyramidal symptoms and myoclonus.Here is a case of an 81-year-old female Filipino with dementia who presented with first-onset generalized choreiform movements.The etiology of the clinical finding of dyskinesia was investigated through laboratories, neuroimaging, and electroencephalogram, all of which yielded negative results. Review of her medications included the rivastigmine (Exelon) patch, which had just been increased to 13.3 mg/24-hour-dose 3 months prior. With all other possible causes excluded, a trial discontinuation of rivastigmine, showed decreased frequency of the dyskinesia 48 hours after, with complete resolution after 6 days, and no recurrence since then.This case thus presents a probable association or causality between the choreiform movement and rivastigmine at 13.3 mg/24-hour-dose patch because of clear temporal proximity, lack of alternative explanations, and a reversal of the dyskinesia upon medicament discontinuation.
authors: From the Department of Neurology and Psychiatry, University of Santo Tomas Hospital, Espana, Manila, Philippines.
authors: Maria Cristina B
authors: MCB
authors: Diaz
authors: Raymond L
authors: RL
authors: Rosales
mesh_terms: D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000188:drug therapy*; D002800:Cholinesterase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects; D020820:Dyskinesias / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D004569:Electroencephalography / Q000379:methods; D005260:Female; D006801:Humans; D059906:Neuroimaging / Q000379:methods; D048448:Phenylcarbamates / Q000008:administration & dosage / Q000009:adverse effects; D000068836:Rivastigmine; D057968:Transdermal Patch; D016896:Treatment Outcome; D028761:Withholding Treatment
chemical_list: D002800:Cholinesterase Inhibitors; D048448:Phenylcarbamates; D000068836:Rivastigmine