{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,22]],"date-time":"2025-10-22T17:55:49Z","timestamp":1761155749007,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 79-year-old woman presented with lower extremity weakness and unsteadiness for 2\u2005weeks. She was recently diagnosed with refractory atrial flutter and was prescribed amiodarone. Physical examination revealed signs of cerebellar dysfunction. Neuroimaging including CT and MRI were unremarkable. Her hospital course included the development of ventricular tachycardia necessitating increment in amiodarone dose. Laboratory studies were unremarkable except mild transaminitis. Other workup including the one for paraneoplastic neurological involvement was negative. The patient experienced worsening of ataxia requiring assistance with ambulation. In view of comprehensive routine negative work-up for ataxia, recent use of amiodarone and worsening of symptomatology with increase in its dosing, drug-induced neurotoxicity from amiodarone was suspected. Amiodarone dose was subsequently reduced and mexilitine was introduced as an additive antiarrhythmic therapy for ventricular tachycardia. In follow-up, the patient experienced significant improvement in her symptoms and was able to ambulate independently. She was subsequently discharged to short-term rehabilitation.<\/jats:p>","DOI":"10.1136\/bcr-2013-200575","type":"journal-article","created":{"date-parts":[[2013,9,26]],"date-time":"2013-09-26T07:36:33Z","timestamp":1380180993000},"page":"bcr2013200575","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Ataxia: a diagnostic perplexity and management dilemma"],"prefix":"10.1136","volume":"2013","author":[{"given":"Vinod K","family":"Chaubey","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Saint Vincent Hospital, University of Massachusetss Medical School, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lovely","family":"Chhabra","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Saint Vincent Hospital, University of Massachusetts Medical School, Worcester, Massachusetts, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aaysha","family":"Kapila","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,9,26]]},"reference":[{"key":"2025082707041236000_2013.sep26_1.bcr2013200575.1","first-page":"865","article-title":"Frequency, characteristics, and risk factors for amiodarone neurotoxicity","volume":"2013","author":"Orr","year":"2009","journal-title":"Arch Neurol"},{"key":"2025082707041236000_2013.sep26_1.bcr2013200575.2","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/S0735-1097(83)80338-6","article-title":"Toxic and therapeutic effects of amiodarone in the treatment of cardiac arrhythmias","volume":"2013","author":"Greene","year":"1983","journal-title":"J Am Coll Cardiol"},{"issue":"(Pt 3)","key":"2025082707041236000_2013.sep26_1.bcr2013200575.3","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1093\/brain\/108.3.753","article-title":"The pathology of amiodarone neurotoxicity. II. Peripheral neuropathy in man","volume":"2013","author":"Jacobs","year":"1985","journal-title":"Brain"},{"issue":"(Pt 3)","key":"2025082707041236000_2013.sep26_1.bcr2013200575.4","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1093\/brain\/108.3.735","article-title":"The pathology of amiodarone neurotoxicity. I. Experimental studies with reference to changes in other tissues","volume":"2013","author":"Costa-Juss\u00e0","year":"1985","journal-title":"Brain"},{"key":"2025082707041236000_2013.sep26_1.bcr2013200575.5","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1001\/archinte.1987.00370050077013","article-title":"Unusual neurotoxicity associated with amiodarone therapy","volume":"2013","author":"Palakurthy","year":"1987","journal-title":"Arch Intern Med"},{"key":"2025082707041236000_2013.sep26_1.bcr2013200575.6","doi-asserted-by":"crossref","first-page":"669","DOI":"10.1212\/WNL.34.5.669","article-title":"Frequent neurologic toxicity associated with amiodarone therapy","volume":"2013","author":"Charness","year":"1984","journal-title":"Neurology"},{"key":"2025082707041236000_2013.sep26_1.bcr2013200575.7","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1212\/WNL.33.5.643","article-title":"Amiodarone neuropathy","volume":"2013","author":"Martinez-Arizala","year":"1983","journal-title":"Neurology"},{"key":"2025082707041236000_2013.sep26_1.bcr2013200575.8","doi-asserted-by":"crossref","first-page":"975","DOI":"10.1016\/0002-8703(85)90238-8","article-title":"Side effects and complications of amiodarone therapy","volume":"2013","author":"Raeder","year":"1985","journal-title":"Am Heart J"},{"key":"2025082707041236000_2013.sep26_1.bcr2013200575.9","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1161\/01.CIR.68.1.88","article-title":"Amiodarone: clinical efficacy and toxicity in 96 patients with recurrent, drug-refractory arrhythmias","volume":"2013","author":"Fogoros","year":"1983","journal-title":"Circulation"},{"key":"2025082707041236000_2013.sep26_1.bcr2013200575.10","doi-asserted-by":"crossref","first-page":"1114","DOI":"10.1016\/S0735-1097(83)80338-6","article-title":"Toxic and therapeutic effects of amiodarone in the treatment of cardiac arrhythmias","volume":"2013","author":"Greene","year":"1983","journal-title":"J Am Coll Cardiol"},{"issue":"(6 Pt 1)","key":"2025082707041236000_2013.sep26_1.bcr2013200575.11","doi-asserted-by":"crossref","first-page":"788","DOI":"10.1016\/0002-8703(80)90057-5","article-title":"Combined mexiletine and amiodarone treatment of refractory recurrent ventricular tachycardia","volume":"2013","author":"Waleffe","year":"1980","journal-title":"Am Heart J"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2013-200575","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T14:04:21Z","timestamp":1756303461000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2013-200575"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2013,9,26]]},"references-count":11,"alternative-id":["10.1136\/bcr-2013-200575"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2013-200575","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2013,9,26]]}}}