Levosulpiride-induced arm-raising stereotypy in a 65-year-old man: an unusual tardive phenomenon

A 65-year-old man presented to us with a 6-month history of recurrent, bilateral, purposeless, arm-raising and lowering movements that fulfilled all criteria for stereotypy. He was on a dopamine blocking agent levosulpiride before the onset of the movements. After the diagnosis of tardive, levosulpiride-induced, armraising stereotypy was made, the offending drug was stopped. Tetrabenazine at 100 mg/day produced near-complete improvement at 3 months. Proximal limb involvement—such as arm-raising—is not reported as a phenotype in tardive stereotypy to date, with all cases having distal hand involvement. Furthermore, any limb stereotypy is not reported with levosupride to date.