{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,18]],"date-time":"2026-05-18T21:10:59Z","timestamp":1779138659227,"version":"3.51.4"},"reference-count":10,"publisher":"Rambam Health Corporation","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Rambam Maimonides Med J"],"abstract":"<jats:p>Movement disorders associated with donepezil have been only rarely reported. Herein, we describe an older woman who developed myoclonus secondary to donepezil. A 61-year-old female presented with brief involuntary twitching. The patient reported that she consulted a general practitioner about 1 month before due to memory complaints. A diagnosis of mild cognitive impairment was made. Donepezil was started. After 4 weeks, she presented to our emergency department due to significant twitching. Multifocal myoclonus was observed. These movements occurred during rest and voluntary movement. Laboratory exams and cerebrospinal fluid analysis were normal. A cranial computed tomography and brain magnetic resonance imaging were unremarkable. Electroencephalography did not show epileptic activity. Electromyography revealed burst durations varying between 50 and 100 ms. Diazepam intravenous was started, which improved her abnormal movement within 1 hour. On the next day, she developed the same clinical symptoms of presentation. Donepezil was discontinued, and clonazepam was started. The patient had a complete recovery from her myoclonus. To the authors\u2019 knowledge, there are six reports of myoclonus secondary to donepezil\/galantamine. There is no report of rivastigmine-induced myoclonus. The most frequent presentation was multifocal myoclonus. The management was the discontinuation of the acetylcholinesterase inhibitor. All the individuals recovered within 3 weeks.<\/jats:p>","DOI":"10.5041\/rmmj.10510","type":"journal-article","created":{"date-parts":[[2023,10,30]],"date-time":"2023-10-30T09:29:56Z","timestamp":1698658196000},"page":"e0023","source":"Crossref","is-referenced-by-count":5,"title":["Action Myoclonus Secondary to Donepezil: Case Report and Literature Review"],"prefix":"10.5041","volume":"14","author":[{"name":"Medicine Department, Federal University of Santa Maria, Santa Maria, Brazil","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jamir Pitton","family":"Rissardo","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Let\u00edcia","family":"Fornari Caprara","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2983","published-online":{"date-parts":[[2023,10,30]]},"reference":[{"key":"ref0","doi-asserted-by":"publisher","first-page":"463","DOI":"10.1016\/j.ejmech.2018.09.031","article-title":"Donepezil-based multi-functional cholinesterase inhibitors for treatment of Alzheimer's disease","volume":"158","author":"Li","year":"2018","unstructured":"1. Li Q, He S, Chen Y, Feng F, Qu W, Sun H. Donepezil-based multi-functional cholinesterase inhibitors for treatment of Alzheimer's disease. Eur J Med Chem 2018;158:463-77.","journal-title":"Eur J Med Chem"},{"key":"ref1","doi-asserted-by":"publisher","first-page":"1036","DOI":"10.1016\/j.jocn.2007.02.082","article-title":"651: Case presentation of myoclonic jerks in a patient with dementia","volume":"14","author":"JG","year":"2007","unstructured":"2. Colebatch JG, Bacsi AM. 651: Case presentation of myoclonic jerks in a patient with dementia. J Clin Neurosci 2007;14:1036-7.","journal-title":"J Clin Neurosci"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"97","DOI":"10.1016\/j.farma.2010.06.001","article-title":"Respiratory myoclonus, a side effect of galantamine","volume":"35","author":"Hern\u00e1ndez-Fern\u00e1ndez","year":"2011","unstructured":"3. Hern\u00e1ndez-Fern\u00e1ndez F, Pardal-Fern\u00e1ndez JM, Garc\u00eda-Mart\u00ednez E, Segura T. Respiratory myoclonus, a side effect of galantamine. Farm Hosp 2011;35:97-9.","journal-title":"Farm Hosp"},{"key":"ref3","unstructured":"4. Luna G, Sharma N, Makela J. C29: Galantamine induced generalized myoclonus. J Am Geriatr Soc 2012;60:S142. ."},{"key":"ref4","doi-asserted-by":"publisher","first-page":"1659","DOI":"10.1177\/1060028014550334","article-title":"Donepezil-induced myoclonus in a patient with Alzheimer disease","volume":"48","author":"Bougea","year":"2014","unstructured":"5. Bougea A, Gerakoulis S, Anagnostou E, Paraskevas G, Kapaki E, Kararizou E. Donepezil-induced myoclonus in a patient with Alzheimer disease. Ann Pharmacother 2014;48:1659-61.","journal-title":"Ann Pharmacother"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"907","DOI":"10.1093\/ageing\/afy093","article-title":"Acute inability to mobilise resulting from probable donepezil-induced myoclonus","volume":"47","author":"Whateley","year":"2018","unstructured":"6. Whateley JM, Huffman AJ, Henderson EJ. Acute inability to mobilise resulting from probable donepezil-induced myoclonus. Age Ageing 2018;47:907-8.","journal-title":"Age Ageing"},{"key":"ref6","unstructured":"7. Amlang C, Kim P, Padalia A, Roy B, Schaefer S. A case of donepezil-induced multifocal myoclonus. Abstract Number 1450. Mov Disord 2019;34(suppl 2):594. Available at: https:\/\/www.mdsabstracts.org\/ abstract\/a-case-of-donepezil-induced-multifocal-myoclonus\/ (accessed August 16, 2023)."},{"key":"ref7","unstructured":"8. Cacabelos R. Donepezil in Alzheimer's disease: from conventional trials to pharmacogenetics. Neuropsychiatr Dis Treat 2007;3:303-33. PMCID: https:\/\/pubmed.ncbi.nlm.nih.gov\/19300564\/"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"345","DOI":"10.1212\/WNL.37.2.345","article-title":"Physostigmine-induced myoclonus in Alzheimer's disease","volume":"37","author":"Mayeux","year":"1987","unstructured":"9. Mayeux R, Albert M, Jenike M. Physostigmine-induced myoclonus in Alzheimer's disease. Neurology 1987;37:345-6.","journal-title":"Neurology"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1136\/jnnp.64.2.281","article-title":"Myoclonus induced by tacrine","volume":"64","author":"Abilleira","year":"1998","unstructured":"10. Abilleira S, Viguera ML, Miquel F. Myoclonus induced by tacrine. J Neurol Neurosurg Psychiatry 1998;64:281.","journal-title":"J Neurol Neurosurg Psychiatry"}],"container-title":["Rambam Maimonides Medical Journal"],"original-title":[],"link":[{"URL":"https:\/\/www.rmmj.org.il\/userimages\/1641\/1\/PublishFiles\/1698Article.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,14]],"date-time":"2024-10-14T11:14:01Z","timestamp":1728904441000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.rmmj.org.il\/issues\/60\/articles\/1698"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,30]]},"references-count":10,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,10,30]]}},"URL":"https:\/\/doi.org\/10.5041\/rmmj.10510","relation":{},"ISSN":["2076-9172"],"issn-type":[{"value":"2076-9172","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,10,30]]}}}