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Case Reports
. 2020 Oct 6:10:37.
doi: 10.5334/tohm.431.

Ziconotide-Induced Oro-lingual Dyskinesia: 3 Cases

Kristopher Grajny  1 , Jennifer Durphy  1 , Octavian Adam  1 , Sharmeen Azher  1 , Megan Gupta  1 , Eric Molho  1
Affiliations
Case Reports

Ziconotide-Induced Oro-lingual Dyskinesia: 3 Cases

Kristopher Grajny et al. Tremor Other Hyperkinet Mov (N Y). .

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.

Keywords: Dysesthesias; Dyskinesia; Lingual; Oral; Ziconotide.

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Conflict of interest statement

The authors have no competing interests to declare.

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