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Ziconotide-Induced Oro-lingual Dyskinesia: 3 Cases.


ABSTRACT: Background:Ziconotide (ZCN), a nonopioid analgesic, is first-line intrathecal therapy for patients with severe chronic pain refractory to other management options. We describe three cases of ZCN-induced movement disorders. Cases:Case one is a 64-year-old woman who presented with oro-lingual (OL) dyskinesia with dysesthesias and bilateral upper extremity kinetic tremor. Case two is a 43-year-old man with a 20-month history of ZCN treatment who developed OL dyskinesia with dysesthesias, involuntary left hand and neck movements, hallucinations, dysesthesias on his feet, and gait imbalance. Case three is a 70-year-old man with a 4-month history of ZCN use who developed OL dyskinesia with dysesthesias. Conclusions:Intrathecal treatment of pain with ZCN may be complicated by a drug-induced movement disorder where OL dyskinesia is characteristic. The movement disorder is likely to be dose related and reversible with ZCN discontinuation, but a chronic movement disorder is also possible.

SUBMITTER: Grajny K 

PROVIDER: S-EPMC7546104 | biostudies-literature | 2020 Oct

REPOSITORIES: biostudies-literature

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Ziconotide-Induced Oro-lingual Dyskinesia: 3 Cases.

Grajny Kristopher K   Durphy Jennifer J   Adam Octavian O   Azher Sharmeen S   Gupta Megan M   Molho Eric E  

Tremor and other hyperkinetic movements (New York, N.Y.) 20201006


<h4>Background</h4>Ziconotide (ZCN), a nonopioid analgesic, is first-line intrathecal therapy for patients with severe chronic pain refractory to other management options. We describe three cases of ZCN-induced movement disorders.<h4>Cases</h4>Case one is a 64-year-old woman who presented with oro-lingual (OL) dyskinesia with dysesthesias and bilateral upper extremity kinetic tremor. Case two is a 43-year-old man with a 20-month history of ZCN treatment who developed OL dyskinesia with dysesthes  ...[more]

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