A Single Dose of Metoclopramide Associated with Extrapyramidal Symptoms in a Child: A Case Report

Wei, Liu Xin

doi:10.19080/jojcs.2018.08.555740

Cited by 3 publications

(7 citation statements)

References 13 publications

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“…Tardive dyskinesia (TD) is a disorder of abnormal muscle movements that is more commonly observed in older individuals with chronic use of DRBAs [1][2][3]. Interestingly, there have been a few cases of acute TD and idiosyncratic drug reactions in young patients using DRBAs [4][5][6]. In one such case report, a 16-year-old male developed TD after two days of oral metoclopramide use [5].…”

Section: Discussionmentioning

confidence: 99%

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Tardive Dyskinesia in a Postoperative Gynecological Patient After Single Dose Administration of Metoclopramide

Wong

Perry

Rosenbaum

2021

Cureus

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Metoclopramide is a dopamine D2-receptor blocking agent commonly used to treat nausea, vomiting, and gastroparesis. Due to their mechanism of action, these drugs can lead to extrapyramidal side effects such as tardive dyskinesia. In this article, we report a case of a nulliparous gynecology patient who developed dyskinetic movements after intraoperative administration of metoclopramide. During further workup after stabilization, she was found to have several risk factors for tardive dyskinesia. As the occurrence of this phenomenon is somewhat rare, this case report aims to discuss the condition, associated risk factors, and differentiation from other diagnoses.

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Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown the development of TD in patients on chronic metoclopramide for gastroparesis [3]. However, there have only been a few case reports of TD in patients using metoclopramide acutely for nausea and vomiting [4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Tardive Dyskinesia in a Postoperative Gynecological Patient After Single Dose Administration of Metoclopramide

Wong

Perry

Rosenbaum

2021

Cureus

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“…If metoclopramide is administered, especially intravenously, it must be given slowly over a duration of three minutes or more. The dose of the drug should be limited to less than 0.5 mg per day with a total duration of administration of not more than five days [18].…”

Section: Discussionmentioning

confidence: 99%

Perioperative Dystonia Mimicking Convulsion: Awareness Is the Key to Diagnosis

Swain¹,

Nag²

2021

Cureus

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Dystonia, a variant of acute extrapyramidal symptoms (EPS), is a known side effect of neuroleptics. It is a rare but well-recognized complication in perioperative settings. Most of the reported cases have been linked to the perioperative use of metoclopramide. Dystonic reactions typically present as repetitive movements or abnormal posturing of the head, neck, and body. These reactions usually last only for a few minutes and are rarely lethal. However, occasionally they may present as sustained laryngopharyngeal muscle spasms, potentially leading to fatal airway obstruction. In this report, we present the case of an elderly female patient who developed a life-threatening episode of dystonia mimicking convulsion in the postoperative period. She had received metoclopramide as pre-anesthetic medication before surgery.

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“…Sequential reports of complications such as acute dysplasia, Parkinsonism, and delayed dystonia also indicate that metoclopramide can bring about extrapyramidal symptoms and drug-induced motor side effects (15,16). Although metoclopramide causes ocular and pyramidal complications and NMS as a worse form, it is being widely used in clinical practice (17). The onset of this side effect varies following metoclopramide intake, although it occurs more commonly within the first two weeks of consumption.…”

Section: Neuroleptic Malignant Syndrome and Metoclopramidementioning

confidence: 99%

“…Moreover, dantrolene has been positive in treating this syndrome, leading to dramatic and immediate reductions in muscle rigidity and body temperature. The benefits of dantrolene are probably related to its muscle relaxant effects (14,17). It should be noted that drug treatment is not helpful in all cases.…”

Section: Neuroleptic Malignant Syndrome General Management and Clinical Outcomesmentioning

confidence: 99%

Metoclopramide-Induced Neuroleptic Malignant Syndrome: A Review Study

Ghafour

Elyasi

2020

Iran J Psychiatry Behav Sci

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Context: Neuroleptic malignant syndrome (NMS) has been introduced as a rare but lethal and idiosyncratic reaction to neuroleptics/antipsychotics. The most obvious risk of this syndrome is the use of neuroleptics, especially high-potency ones. Metoclopramide is also known as an anti-nausea medication administered before surgery to manage digestive problems. Evidence Acquisition: Formerly, it had been assumed that metoclopramide was a type of chlorobenzamide that was not in the phenothiazine group but free of extrapyramidal side effects (EPSs). The sequential reports of complications indicate that metoclopramide can cause EPSs and drug-induced motor side effects. A total number of 5,046 articles were obtained after the initial search. Then, two researchers independently screened out their titles, and abstracts and 20 articles were finally selected based on the inclusion criteria. Results: Of the 20 articles reporting metoclopramide-induced NMS, treatments had been successful in 16 (80%) cases, but it had led to death in four (20%) patients. There were 11 and 8 male and female patients, respectively, and gender was not mentioned for a patient in one article. The age range of the patients was from six months to 84 years, and the mean age was 50.92 years. Conclusions: Although NMS following metoclopramide intake is reported very rarely, it should be considered for any psychiatric symptoms with unexpected mental changes, muscle rigidity, and fever after being treated with metoclopramide. The neuroleptic malignant syndrome can occur following multiple doses or just one dose of metoclopramide. Also, metoclopramide use in patients affected with kidney failure is accompanied by a higher risk of NMS. A previous history of NMS, a recent episode of catatonia, and severe agitation are all taken into account as risk factors in this domain.

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A Single Dose of Metoclopramide Associated with Extrapyramidal Symptoms in a Child: A Case Report

Cited by 3 publications

References 13 publications

Tardive Dyskinesia in a Postoperative Gynecological Patient After Single Dose Administration of Metoclopramide

Tardive Dyskinesia in a Postoperative Gynecological Patient After Single Dose Administration of Metoclopramide

Perioperative Dystonia Mimicking Convulsion: Awareness Is the Key to Diagnosis

Metoclopramide-Induced Neuroleptic Malignant Syndrome: A Review Study

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