Objective: Our aim is to report unusual case of woman who presented asymmetrical resting tremor of both legs induced by levosulpiride.

Background: Resting tremor of lower legs is an uncommon symptom of neurological disease and lower limb tremor is known as an unusual initial manifestation of Parkinson’s disease.

Method: Single case report and description of clinical characteristics.

Results: A Korean woman was referred to our neurologic department due to involuntary tremorous movements of both legs. She presented relatively subacute-onset, asymmetrical resting tremor of both legs several weeks ago. She had a few-year history of dyspepsia, and she had been taking levosulpiride at a dose of 75mg/day for several months. She had no parkinsonian symptoms, and other neurological examination, electrophysiological tests and brain imaging including dopamine transporter imaging with [F-18] FP-CIT PET were normal without asymmetrical resting tremor of both legs. After levosulpiride was discontinued, her asymmetrical resting tremor symptoms of lower legs gradually improved and completely resolved two weeks later.

Conclusion: To our knowledge, this is the first case report of asymmetrical resting tremor of both legs induced by levosulpiride. As like this case, if there is isolated, unilateral or asymmetrical, bilateral resting tremor of lower limb, it should be considered not only diagnosis of Parkinson’s disease, but also drug-induced tremor or drug-induced parkinsonism.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/asymmetrical-resting-legs-tremor-induced-by-levosulpiride/