Movement disorders secondary to adulterated medication

Diagnosis of drug-induced movement disorders (DIMD) may prove troublesome because they can manifest after a long delay1,2 and the patient may be unable to recall his or her pharmacologic history. Also, the list of drugs capable of inducing movement disorders continues to increase.3,4 We present a series of patients, seven from Peru (who were prescribed an antibiotic) and four from Argentina with PD (treated with l-dopa–benserazide), who developed movement disorders or exhibited worsening of a pre-existing abnormal movement, without reliable information as to the true nature of the drugs taken. ### Case 4. An 83-year-old Argentinian man with a 13-year history of PD in Hoehn and Yahr stage III, currently receiving l-dopa–benserazide 700–175 mg/day plus pergolide 3 mg/day, presented with end-of-dose deterioration associated with mild peak-of-dose dyskinesias. On admission he had severe worsening of parkinsonian signs, which had occurred during the last 10 days. On examination, he was extremely bradykinetic with severely …