title: Reversible craniocervical dystonia associated with levofloxacin.
abstract: BACKGROUND
  Dystonia is a hyperkinetic movement disorder related to dysfunction of inhibitory basal ganglia and cortical circuits. GABA is the major inhibitory neurotransmitter in the central nervous system. Quinolones can rarely produce serious neurologic effects, which have been attributed to impaired inhibition through GABA antagonism. We report a case of reversible craniocervical dystonia associated with oral levofloxacin.
  
  
  METHODS
  A 62-year-old man on hemodialysis presented with craniocervical dystonia 3 days after initiation of levofloxacin 500 mg. twice daily. Levofloxacin was discontinued. Seven days later the abnormal movements completely disappeared and did not recur in the following 3 months.
  
  
  CONCLUSIONS
  Levofloxacin should be considered as a rare but potentially reversible trigger of craniocervical dystonia. Older age, renal impairment and high doses of the drug might be risk factors.
authors.affiliation: Department of Neurology, University of Miami, Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, 13th Floor, Miami, FL 33136 USA.
authors.forename: Karlo J
authors.initials: KJ
authors.lastname: Lizarraga
authors.affiliation: Department of Neurology, University of Miami, Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, 13th Floor, Miami, FL 33136 USA.
authors.forename: Maria R
authors.initials: MR
authors.lastname: Lopez
authors.affiliation: Department of Neurology, University of Miami, Miller School of Medicine, Clinical Research Building, 1120 NW 14th Street, 13th Floor, Miami, FL 33136 USA.
authors.forename: Carlos
authors.initials: C
authors.lastname: Singer
keywords: Craniocervical dystonia; Levofloxacin; Quinolones; Renal disease