Methylphenidate-Induced Dyskinesia in a 47-Year-Old Female With Acute Lymphoblastic Leukemia

Dyskinesia describes a broad category of involuntary body movements. The presentation of dyskinesia is variable, ranging from quick jerking and twitching to smooth "dance-like" movements. Dyskinesia can occur in the extremities, face, or trunk. They can result from the use of certain medications and various medical conditions. One cause, explored in this paper, is dyskinesia as a side effect of methylphenidate use. We report on a 47-year-old woman with a past medical history of hypoplastic low-grade myelodysplastic syndrome with pancytopenia, acute lymphoblastic leukemia (in remission), and generalized fatigue treated with methylphenidate for her fatigue and decreased concentration. The patient presented from home to the emergency department with expressive aphasia, facial spasming, and involuntary extremity movement. Initial concern for stroke was ruled out and ultimately methylphenidate was determined to be the offending agent. Although our case focuses on an adult, cancer patient affected by dyskinesia following methylphenidate use, dyskinesia is a reported side effect with methylphenidate use in other populations. Clinicians should be aware of this association because of methylphenidate's extensive use in the treatment of attention deficit hyperactivity disorder (ADHD) and its increasing use in other patient populations, like cancer patients and patients with brain injuries.