Rhythmic movement disorder after general anesthesia

Abstract

Dystonic movements after general anesthesia are very rare. The differential diagnosis includes adverse drug reaction, local anesthetic reaction, emergence delirium, hysterical response, and shivering. We present a case of a 10-year-old, otherwise healthy girl undergoing outpatient foot surgery. Involuntary jerking movements of her arms and torso every time she would drift off to sleep started about 2.5 hours after emergence from general anesthesia. The patient was easily arousable and absolutely unaware of the movements. These movements lasted for several days before they resolved completely. We believe to present the first case of sleep-related rhythmic movement disorder after general anesthesia, considering the nature of the movements in our patient.

A boy infant with sleep related rhythmic movement disorder showing arm banging

“…The clinical manifestation of our patient is compatible with RMD, except for the movement involved. Involuntary jerking movements of the arms and torso have been recently reported in a neurologically unaffected 10-year-old girl while recovering from general anesthesia [3] . Su et al reported [4] a 15-year-old boy who presented with multiple complex rhythmic movements during sleep, including bilateral rhythmic arm rocking and rhythmic hand movements.…”