Original Article

Evaluation of Patients with Metoclopramide-Induced Acute Dystonic Reaction

10.5152/jaem.2012.034

  • Sedat Işıkay
  • Kutluhan Yılmaz
  • Mehmet Almacıoğlu

Received Date: 13.02.2012 Accepted Date: 03.04.2012 Eurasian J Emerg Med 2013;12(2):80-84

Objective:

Metoclopramide is a medication used as an antiemetic in children. Its most significant side effect is acute dystonic reactions requiring emergency treatment. This study evaluates some cases in which metoclopramide- induced acute dystonic reactions developed at a pediatric emergency department. Material and

Material and Methods:

The study includes 11 children admitted to the Pediatric Emergency Department due to medication-induced dystonia.

Results:

The average medication time of patients was 40±35.35 hours, the average development period of dystonia after medication was 1.48±0.85 hours and the average time to complete recovery after treatment was 1±0.33 hours. Two of the cases were pre-diagnosed as convulsions, two as encephalitis, one as food poisoning, one as intoxication and one as a drug reaction. All cases presented with an acute dystonic reaction upon physical examination. Torticollis was observed in all cases, oculogyric crisis in seven cases, opisthotonos in two cases, tongue protrusion in two cases and contraction and increased tonus of the arms and legs in one case. Biperiden lactate was administered to all cases and rapid and complete recovery was observed.

Conclusion:

Dystonia can easily be mistaken for other conditions due to its infrequency in routine pediatric cases when this movement disorder is compared with developing cases. It should be considered that patients who develop movement disorders and whose history includes metoclopramide usage may have a medication-induced dystonic reaction.

Keywords: Metoclopramide, vomiting, antiemetic, acute dystonic reaction, child