A case of a methadone-induced movement disorder

Objective: To increase awareness of the possibility of opioid induced movement disorders. Setting: A university-affiliated Veterans Affairs Hospital. Patient: A patient with upper extremity pain due to complex regional pain syndrome type I (reflex sympathetic dystrophy). Interventions: Attempted pain control with methadone. Results and Conclusions: After failing many attempts at control, the authors were able to provide their patient significant pain relief from her complex regional pain syndrome type I using methadone. Unfortunately, the patient eventually developed a movement disorder, characterized by tremor, choreiform movements, and a gait abnormality, probably related to this opioid. The authors conclude that, while this type of movement disorder is uncommon, clinicians need to be aware of opioid-induced movement disorders, because they are disturbing to patients and often easily treated.