Rhabdomyolysis Associated with Severe Levodopa-Induced Dyskinesia in Parkinson's Disease: A Report of Two Cases and Literature Review.

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.