Case Report
Copyright ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Dec 6, 2022; 10(34): 12726-12733
Published online Dec 6, 2022. doi: 10.12998/wjcc.v10.i34.12726
Amiodarone-induced muscle tremor in an elderly patient: A case report
Xiao-Yong Zhu, Xin-Hu Tang, Hua Yu
Xiao-Yong Zhu, Xin-Hu Tang, Hua Yu, Department of Cardiology, Jiujiang University Affiliated Hospital, Jiujiang 332000, Jiangxi Province, China
Author contributions: Zhu XY reviewed the literature and contributed to manuscript drafting and revising; Zhu XY was the patient’s doctor and contributed to collecting the patient’s medical data and making a revision to the manuscript; Tang XH and Yu H were responsible for the revision of the manuscript for important intellectual content; all authors issued final approval for the version to be submitted.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Xin-Hu Tang, PhD, Professor, Department of Cardiology, Jiujiang University Affiliated Hospital, No. 57 Road, Xunyang District, Jiujiang 332000, Jiangxi Province, China. 18879292198@163.com
Received: September 3, 2022
Peer-review started: September 3, 2022
First decision: September 27, 2022
Revised: October 9, 2022
Accepted: November 4, 2022
Article in press: November 4, 2022
Published online: December 6, 2022
Abstract
BACKGROUND

Amiodarone is a Class III antiarrhythmic drug, which has been adopted for the treatment of atrial fibrillation and ventricular arrhythmia. However, the use of amiodarone can cause lower limb muscle tremors, which is recognized as a rare side effect of this medication.

CASE SUMMARY

An 84-year-old female was administrated with amiodarone for paroxysmal supraventricular tachycardia and frequent ventricular tachycardia. The patient developed a bilateral gastrocnemius tremor in the course of medication, and the strength of the patient’s bilateral knee flexor and extensor reached 4/5 and 3/5, respectively. After the use of amiodarone was stopped, and the patient was given a small dose of levetiracetam, the lower limb tremor symptoms were significantly mitigated, along with activity and function.

CONCLUSION

Attention should be paid to the significance of the side effects of drugs in the elderly, which may be atypical in the elderly. The relevant side effects of drugs may not be as rare as reported due to individual differences and different pharmacokinetics. If the side effects are generated, the medication should be adjusted in time, and the progress of the side effects should be intervened.

Keywords: Adverse reaction, Arrhythmia, Muscle disease, Amiodarone, Levetiracetam, Case report

Core Tip: A patient who developed lower limb muscle tremors after the use of amiodarone was administrated with supraventricular tachycardia and frequent ventricular tachycardia. The symptoms was mitigated continuously. After the use of amiodarone was stopped, and the patient was given levetiracetam, the symptoms were gradually mitigated. This type of adverse reaction to amiodarone has been rare. The adverse reaction caused by amiodarone should be considered when similar symptoms occur during diagnosis and treatment.