Oromandibular Dyskinesia Associated With Levofloxacin and Responsive to Low-Dose Oral Diazepam: A Case Report

Oromandibular dyskinesia (OMD) is a rare movement disorder characterized by involuntary, repetitive, and often uncontrolled movements of the jaw, lips, and tongue. It may be associated with antipsychotics, antidepressants, anticonvulsants, and antibiotics. The OMD caused by antibiotics is very rare and often overlooked.

We report here an 89-year-old female patient who had chewing-like oromandibular dyskinesia, defined by vertical jaw opening and closing motions, on the third day of oral levofloxacin medication, which began for community-acquired pneumonia. After cessation of levofloxacin and initiation of low-dose diazepam (5 mg/d), dramatic clinical improvement was observed within 48 hours, with symptoms nearly fully resolved by day 7.

Fluoroquinolones can rarely cause movement disorders like OMD. The exact mechanism is unknown, but it may involve GABA imbalance. Stopping the drug and starting benzodiazepines may lead to a fast recovery.