Rhabdomyolysis associated with severe levodopa-induced dyskinesia in parkinson’s disease: A report of two cases and literature review

Abstract

Background: Rhabdomyolysis associated with levodopa-induced dyskinesia (Rhab-LID) is an extremely rare, life-threatening, but treatable condition in patients with Parkinson’s disease (PD). Case report: We reported two cases of Rhab-LID. The first case was a 64-year-old man presenting with severe generalized dyskinesia with elevated serum creatine kinase (CK) level. He was diagnosed with Rhab-LID owing to unpredictable gastric emptying time. The second case was a 61-year-old woman presenting with fever, myalgia, and disabling dyskinesia with elevated serum CK. She was diagnosed with dyskinesia-hyperpyrexia syndrome (DHS) due to increasing dosage of ropinirole and infection. Dopaminergic medications were stopped, and supportive care was initiated in both cases with excellent outcomes. Conclusion: Early recognition, stopping dopaminergic medications, treating precipitating causes, and proper supportive treatment can provide favorable outcomes.