Levofloxacin-induced myoclonus and encephalopathy

• Published in: Annals of the Indian Academy of Neurology Vol. 23; no. 3; pp. 405 - 407
• Main Authors: Reddy, V, Mittal, Gaurav, Sekhar, Shilpa, Singhdev, Jennifer, Mishra, Rakesh
• Format: Journal Article
• Language: English
• Published: Mumbai Wolters Kluwer India Pvt. Ltd 01-05-2020; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd; Wolters Kluwer - Medknow; Wolters Kluwer Medknow Publications
• Subjects: Alanine; Alanine transaminase; Alkaline phosphatase; Ammonia; Antibiotics; Aspartate aminotransferase; Bacterial infections; Binding sites; Blood pressure; Body temperature; Calcium; Coma; Complications and side effects; Creatinine; Creutzfeldt-Jakob disease; Dementia disorders; Drug resistance; Electroencephalography; Encephalitis; Encephalopathy; Heart rate; Hemoglobin; Hyperammonemia; Imipenem; Intravenous immunoglobulins; Letters to the Editor; Levofloxacin; Lewy bodies; Lungs; Myoclonus; Nervous system diseases; Neurotoxicity; Pantoprazole; Peroxidase; Psychosis; Pyruvic acid; Respiration; Thyroid; Thyroxine; Triiodothyronine
• ISSN: 0972-2327; 1998-3549
• DOI: 10.4103/aian.AIAN_429_19

[MULTIMEDIA:1] Vitals initially recorded were as follows: blood pressure of 110/70 mm Hg, heart rate 82 beats per minute, temperature 37.8°C, respiratory rate 20 breaths per minute, oxygen saturation 98% on room air. Laboratory findings revealed a white cell count of 9,200/μL, hemoglobin level of 12.7, platelet count of 250,000/μL, ESR of 48 mm in 1st h, aspartate aminotransferase 22 U/L, alanine aminotransferase 11 U/L, alkaline phosphatase 74 U/L, blood urea nitrogen 14.5 mg/dl, creatinine 0.84 mg/dl, sodium 140 mEq/L, potassium 3.97 mEq/L, calcium 8.9 mg/dl, albumin 3.75 g/dL, thyroid stimulating hormone 5.81 IU/ml, free T3 2.97 pg/ml, free T4 0.64 ng/dl, antithyroid peroxidase antibody 1 IU/ml, ammonia 59 mol/L, vit B12 >1500 pg/ml, creatinine kinase (NAC) 90 U/L, pyruvate 0.36. Other probabilities in our case were Creutzfeldt-jakob disease (CJD), dementia with lewy body (DLB), Hashimoto's encephalopathy (HE), and hyperammonemia which were ruled out clinically and with specific investigations.