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Abstract

Dystonia is a rare neurologic disorder of the basal ganglia presenting with involuntary twisting or turning spasm of muscles. Movements localized to the face, eyes, or neck generally present during late adulthood. Cranial dystonia is usually idiopathic but may be caused by trauma or medications. Of 148 patients with focal dystonia referred to Indiana University over four years, four women had the onset of face and neck symptoms eight days to 34 months after completing treatment with chemotherapy alone or combined with radiation therapy. Two patients were treated with 5-FU, one received doxorubicin and one was treated with both. Both drugs have been associated with transient parkinsonism, but no chemotherapeutic medications have been reported to cause dystonia. Three patients remain free of demonstrable malignancy. A possible association of chemotherapy and focal dystonia has not been previously described.

Oromandibular dystonia: a serious side effect of capecitabine

“…To the best of our knowledge oromandibular dystonia is never reported after the administration of other forms of 5-FU. Focal dystonia, however, caused by 5-FU has been reported in one earlier case series including three cases [ 6 ]. Due to the serious nature of this adverse event, although rare, we are convinced that physicians should be aware of this.…”

Metoclopramide-Induced Acute Dystonic Reactions May Be Associated With the CYP2D6 Poor Metabolizer Status and Pregnancy-Related Hormonal Changes

“…In the CYP2D6 –metoclopramide case report, the chemotherapy that the patients received could have been equally culpable of the dystonic reactions. Chemotherapeutic agents have been reported to cause dystonia, possibly by adversely affecting the movement-related brain circuits, i.e., those housed in the basal ganglia (Brashear and Siemers, 1997).…”