Pemoline-induced choreoathetosis and rhabdomyolysis

Pemoline is an indirectly acting sympathomimetic with actions similar to amphetamine and methylphenidate. While choreoathetosis is a well-recognised complication of acute or chronic amphetamine abuse, only 3 previous case reports have implicated pemoline in such a movement disorder. We report a 49-year-old man who developed severe choreoathetosis with rhabdomyolysis after markedly increasing his intake of pemoline. Abnormal movements responded to diazepam and completely resolved over 48 hours. He made a complete recovery with supportive care. This is only the second case of pemoline-induced choreoathetosis in an adult reported in the English literature, and the first case of rhabdomyolysis and myoglobinuria complicating choreoathetosis.