A case of a methadone-induced movement disorder

To increase awareness of the possibility of opioid induced movement disorders.

A university-affiliated Veterans Affairs Hospital.

A patient with upper extremity pain due to complex regional pain syndrome type I (reflex sympathetic dystrophy).

Attempted pain control with methadone.

After failing many attempts at control, the authors were able to provide their patient significant pain relief from her complex regional pain syndrome type I using methadone. Unfortunately, the patient eventually developed a movement disorder, characterized by tremor, choreiform movements, and a gait abnormality, probably related to this opioid. The authors conclude that, while this type of movement disorder is uncommon, clinicians need to be aware of opioid-induced movement disorders, because they are disturbing to patients and often easily treated.