Metoclopramide
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Metoclopramide Tardive dyskinesia successfully treated with levetiracetam in an elderly patient: case report A 68-year-old woman developed tardive dyskinesia while receiving metoclopramide for gastrointestinal dysmotility subsequent to intestinal transplantation; she was successfully treated with levetiracetam. The woman had been receiving oral metoclopramide for > 10 years (mostly at 5–10mg three times daily) and was diagnosed with tardive dyskinesia [time to reaction onset not stated]. She presented with stereotypical orofacial and rightsided involuntary choreiform movements of her upper and lower extremities. At this time, she was also receiving tacrolimus, loperamide, cotrimoxazole [sulfamethoxazole/ trimethoprim] and insulin. On examination, she had stereotypical orofacial dyskinesias with blepharospasm and chewing movements, right-sided hemiballistic movements with chorea and shoulder shrugging, and an Abnormal Involuntary Movement Scale (AIMS) score of 27. Treatment with gabapentin did not improve the woman’s involuntary movements, and she only showed a mild response to clonazepam. Oral levetiracetam was then initiated and her involuntary movements improved within a week. At 4 months’ follow-up, her AIMS score was 8. Her dyskinesia did not worsen for > 18 months and metoclopramide was continued. ˇ Zivkovi´ c SA, et al. Treatment of tardive dyskinesia with levetiracetam in a transplant patient. Acta Neurologica Scandinavica 117: 351-353, No. 5, May 2008 801097832 - USA
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Reactions 5 Jan 2008 No. 1183
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