Tardive dyskinesia (TD) is one of the most worrisome side efects associated to narcoleptics treatment (1, 2). Repetitive and patterned movement characterizes this condition. The most typical form of TD is oro-lingual-masticatory the movement (3). We report a patient who developed a TD after 9 month of treatment with rivastigmine (cholinesterase inhibitor). Continuos cholinergicdopaminergic misbalance could be a factor in the pathophysiology of TD.