Main Article Content
Abstract
Cervical dystonia, is a neurological condition characterized by involuntary neck muscle contractions, abnormal head and neck postures. This case report describes a 63-year-old male with Parkinsonism and early dementia who developed severe cervical dystonia after starting Donepezil, a cholinesterase inhibitor used to manage cognitive impairment. The patient came with complaints of difficulty in sitting, mild rigidity and anterior neck flexion. Discontinuation of Donepezil led to significant improvement; subsequent treatment with Trihexyphenidyl was effective. This case underscores the importance of monitoring for rare but serious side effects of cholinesterase inhibitors and highlights the need for further research into their mechanisms and risk factors.
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References
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References
1. Ikeda K, Yanagihashi M, Sawada M, Hanashiro S, Kawabe K, Iwasaki Y. Donepezil-induced cervical dystonia in Alzheimer's disease: a case report and literature review of dystonia due to cholinesterase inhibitors. Internal Medicine. 2014;53(9):1007-10.
2. Baba T, Takeda A, Murakami A, Koga T, Isomura T, Mori E, Hisanaga K, Ugawa Y, Hattori N, Murata M, Hasegawa K. Effect of donepezil for dementia prevention in Parkinson's disease with severe hyposmia (The DASH-PD study): A randomized long-term placebo-controlled trial. E Clinical Medicine. 2022 Sep 1;51.
3. Crowner BE. Cervical dystonia: disease profile and clinical management. Physical therapy. 2007 Nov 1; 87(11): 1511-26.
4. Hasegawa, N., Shimada, K., Yamamoto, Y., Maeda, K. A case of dementia with Lewy bodies presenting with cervical dystonia after administration of donepezil hydrochloride. Clinical Neurology. 2010; 50(3): 147-50.
5. Ravina B, Putt M, Siderowf A, Farrar JT, Gillespie M, Crawley A, Fernandez HH, Trieschmann MM, Reichwein S, Simuni T. Donepezil for dementia in Parkinson’s disease: a randomised, double blind, placebo controlled, crossover study. Journal of Neurology, Neurosurgery & Psychiatry. 2005 Jul 1;76(7):934-9.
6. Burt T. Donepezil and related cholinesterase inhibitors as mood and behavioral controlling agents. Current psychiatry reports. 2000 Dec;2(6):473-8.
7. Baik K, Kim SM, Jung JH, Lee YH, Chung SJ, Yoo HS, Ye BS, Lee PH, Sohn YH, Kang SW, Kang SY. Donepezil for mild cognitive impairment in Parkinson’s disease. Scientific reports. 2021 Feb 26;11(1):4734.
8. Available from: https://who umc.org/media/164200/who umccausality assessment_new logo.pdf. [Last accessed on 2024 Jun 11].
9. Adverse drug reactions [Internet]. 2015. Available from: https://clinicalgate.com/adverse drugreactions/#:~:text=Rawlins%E2%80%93Thompson%20,classification,pharmacological%20effects%20of%20a%20drug. [Last accessed on 2024 Jun 11].
10. Petrova G, Stoimenova A, Dimitrova M, Kamusheva M, Petrova D, Georgiev O. Assessment of the expectancy, seriousness and severity of adverse drug reactions reported for chronic obstructive pulmonary disease therapy [Internet]. U.S. National Library of Medicine; 2017. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5308439/. [Last accessed on 2024 Jun 11].
11. Iftikhar S, Sarwar MR, Saqib A, Sarfraz M. Causality and preventability assessment of adverse drug reactions and adverse drug events of antibiotics among hospitalized patients: A Multicenter, cross sectional study in Lahore, Pakistan [Internet]. U.S. National Library of Medicine; 2018. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6021047/. [Last accessed on 2024 Jun 11].
12. www.vigiaccess.org Vigiaccess database