LAUSR

Dear Editor, Drugs are an important cause of tremor in the elderly and the second most common cause of Parkinsonism. Common medications which induce tremor include salbutamol, theophylline, valproate, anti-depressants, anti-psychotics, and anti-dopaminergics [1, 2]. The T-type calcium channel blockers (CCBs), cinnarizine and flunarizine, are classically associated with a syndrome known as the Bde Melo-Souza ’s syndrome,^ or flunarizine-cinnarizine-induced Parkinsonism (FCIP) [3, 4]. FCIP is diagnosed in a patient on these drugs, with any two of tremor, hypokinesia, rigidity, and postural instability. In its classic form, it mimics idiopathic Parkinson’s disease. The syndrome is often associated with depression and other features may include anxiety, insomnia, decreased facial expression, decreased deep tendon reflexes, and generalized weakness. Older females are the usual victims and the symptoms resolve following discontinuation of the concerned CCB [3, 4]. We present the case of an elderly female with partly similar manifestations after exposure to the L-type calcium channel blockers nifedipine and amlodipine. Case report