Metoclopramide-induced oculogyric crisis presenting as encephalitis in a young girl

Arumugam, Jayavardhana; Vijayalakshmi, A M

doi:10.4103/0253-7613.93867

Cited by 13 publications

(23 citation statements)

References 11 publications

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“…Acute dystonic reactions, the most common adverse extrapyramidal effects of metoclopramide are characterized by involuntary, slow and sustained or spasmodic contractions of muscle groups which may result in twisting, repetitive movements and abnormal posturing. They usually present as oculogyric crisis, torticollis or opisthotonus, rhythmic protrusion of the tongue, facial grimacing, trismus and bulbar speech [8, 11-13]. In our case, the patient presented with an acute dystonic reaction in the form of torticollis.…”

Section: Discussionmentioning

confidence: 71%

Acute Dystonic Reaction in a 14-Year-Old Boy after Accidental Overuse of Nasal Metoclopramide

et al. 2021

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We present the case of a 14-year-old boy who developed an acute dystonic reaction 5 h following the overuse of a nasal metoclopramide spray that his mother gave him thinking it was a nasal decongestant. The patient had torticollis and intense motor restlessness, while he was fully conscious and hemodynamically stable. All laboratory investigations were normal. He was treated with a single dose of biperiden intravenously with direct disappearance of the symptoms. Children are particularly susceptible to the extrapyramidal side effects of metoclopramide that can occur irrespective of the route of administration.

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Section: Discussionmentioning

confidence: 71%

Acute Dystonic Reaction in a 14-Year-Old Boy after Accidental Overuse of Nasal Metoclopramide

et al. 2021

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“…Acute dystonic reactions can be confused with conversion disorders, seizures, encephalitis, tetanus and hypocalcemic tetany (1,7,10). Our patient was brought into the emergency department by an emergency ambulance crew, with the initial diagnoses of conversion and epileptic seizure.…”

Section: Discussionmentioning

confidence: 94%

Metoclopramide-induced acute dystonic reaction misinterpreted as conversion disorder and seizure

et al. 2017

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Metoclopramide, an antiemetic, is the most common cause of drug-induced dystonic reactions. 20-year-old female patient, complaining of involuntary bilateral upward medial deviation of the eyes, generalized muscle contractions and uncontrollable cry was brought into the emergency department(ED) by an ambulance. The diagnosis of the ambulance crew was conversion or seizure. The patient has all of dystonic reaction symptoms, including facial, neck, back, and extremity spasms, opisthotonus, oculogyric crisis, torticollis, trismus. The history revealed 40 mg of metoclopramide intake. Biperiden (5 mg) was infused in 100 ml saline. Symptoms were completely resolved. She was discharged from the ED. Drug-induced dystonic reactions can be confused with conversion, seizures, encephalitis, tetanus and hypocalcemic tetany. It is important for emergency physicians to know the drugs that may have dystonic reaction as potential side effects, recognize the clinical presentation of drug-induced dystonic reactions, and properly manage them in the ED.

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“…We found nine articles reporting OGCs in ten female patients and one male patient (median age: 21 years; range: 13 to 55 years) receiving antiemetics. Oculogyric crises were reported in five patients following intake of metoclopramide [23][24][25][26][27], in three patients upon administration of phenothiazines [28] used as antiemetics, and also in single cases associated with intake of clebopride, ondansetron and droperidol [29][30][31].…”

Section: Antiemeticsmentioning

confidence: 99%

Oculogyric crises: Etiology, pathophysiology and therapeutic approaches

Barow

Schneider

Bhatia

et al. 2017

Parkinsonism & Related Disorders

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Oculogyric crisis (OGC) describes the clinical phenomenon of sustained dystonic, conjugate and typically upward deviation of the eyes lasting from seconds to hours. It was initially observed in patients with postencephalitic parkinsonism, but since then a number of conditions have been associated with OGC. These include drug-induced reactions, hereditary and sporadic movement disorders, and focal brain lesions. Here, we systematically review the literature and discuss the spectrum of disorders associated with OGC in order to aid clinicians place this rare but distinctive clinical sign into the appropriate diagnostic context. We also provide a brief synthesis of putative pathophysiological mechanisms, as well as therapeutic recommendations based on the literature and our own experience.

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Metoclopramide-induced oculogyric crisis presenting as encephalitis in a young girl

Cited by 13 publications

References 11 publications

Acute Dystonic Reaction in a 14-Year-Old Boy after Accidental Overuse of Nasal Metoclopramide

Acute Dystonic Reaction in a 14-Year-Old Boy after Accidental Overuse of Nasal Metoclopramide

Metoclopramide-induced acute dystonic reaction misinterpreted as conversion disorder and seizure

Oculogyric crises: Etiology, pathophysiology and therapeutic approaches

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