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Published in: Journal of Medical Case Reports 1/2021

Open Access 01-12-2021 | Dystonia | Case report

Metoclopramide-induced acute dystonic reactions: a case report

Authors: Ritesh Chaudhary, Gyanendra Malla, Monika Kadayat

Published in: Journal of Medical Case Reports | Issue 1/2021

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Abstract

Background

Acute dystonic reactions caused by drugs are uncommon in daily practice, whether in outpatient or in emergency settings. Such types of unfavorable reaction may cause the treating physician’s working diagnosis to be misled at a certain point.

Case presentation

A 25-year-old Hindu female from Dharan with no previous medical history was being treated for acid peptic disease. Her local physician prescribed oral tablet metoclopramide 10 mg three times a day for 7 days and tablet pantoprazole 40 mg once daily for 7 days. After 24 hours of ingestion of 10 mg of tablet metoclopramide, she was admitted to our Koirala Institute of Health Sciences emergency department with sudden history of facial twitching, slurred speech, and abnormal tongue protrusion. Metoclopramide-induced acute dystonic reaction was diagnosed. After resuscitation, her symptoms reduced quickly, and she was successfully discharged home the same day.

Conclusions

Early diagnosis would be aided by the use of clinical background along with focus on drug history usage, preventing life-threatening pitfalls. To decrease the acute dystonic reaction associated with metoclopramide use, higher frequency of prescription patterns should be taken into account.
Literature
1.
go back to reference Miller LG, Jankovic J. Metoclopramide-induced movement disorders: clinical findings with a review of the literature. Arch Intern Med. 1989;149(11):2486–92.CrossRef Miller LG, Jankovic J. Metoclopramide-induced movement disorders: clinical findings with a review of the literature. Arch Intern Med. 1989;149(11):2486–92.CrossRef
2.
go back to reference Pasricha PJ, Pehlivanov N, Sugumar A, Jankovic J. Drug insight: from disturbed motility to disordered movement—a review of the clinical benefits and medicolegal risks of metoclopramide. Nat Clin Pract Gastroenterol Hepatol. 2006;3(3):138–48.CrossRef Pasricha PJ, Pehlivanov N, Sugumar A, Jankovic J. Drug insight: from disturbed motility to disordered movement—a review of the clinical benefits and medicolegal risks of metoclopramide. Nat Clin Pract Gastroenterol Hepatol. 2006;3(3):138–48.CrossRef
3.
go back to reference Morgan GE, Mikhail MS, Murray MJ. Adjuncts to anesthesia. In: Morgan GE, Mikhail MS, Murray MJ, editors. Clinical anesthesiology. 5th ed. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division; 2013. p. 292–308. Morgan GE, Mikhail MS, Murray MJ. Adjuncts to anesthesia. In: Morgan GE, Mikhail MS, Murray MJ, editors. Clinical anesthesiology. 5th ed. New York: Lange Medical Books/McGraw-Hill Medical Publishing Division; 2013. p. 292–308.
4.
go back to reference Moos DD, Hansen DJ. Metoclopramide and extrapyramidal symptoms: a case report. J Perianesth Nurs. 2008;23(5):292–9.CrossRef Moos DD, Hansen DJ. Metoclopramide and extrapyramidal symptoms: a case report. J Perianesth Nurs. 2008;23(5):292–9.CrossRef
5.
go back to reference Oyewole A, Adelufosi A, Abayomi O. Acute dystonic reaction as medical emergency: a report of two cases. Ann Med Health Sci Res. 2013;3(3):453–5.CrossRef Oyewole A, Adelufosi A, Abayomi O. Acute dystonic reaction as medical emergency: a report of two cases. Ann Med Health Sci Res. 2013;3(3):453–5.CrossRef
6.
go back to reference Bateman DN, Darling WM, Boys R, Rawlins MD. Extrapyramidal reactions to metoclopramide and prochlorperazine. Q J Med. 1989;71(264):307–11.PubMed Bateman DN, Darling WM, Boys R, Rawlins MD. Extrapyramidal reactions to metoclopramide and prochlorperazine. Q J Med. 1989;71(264):307–11.PubMed
7.
go back to reference Tianyi FL, Agbor VN, Njim T. Metoclopramide induced acute dystonic reaction: a case report. BMC Res Notes. 2017;10(1):32.CrossRef Tianyi FL, Agbor VN, Njim T. Metoclopramide induced acute dystonic reaction: a case report. BMC Res Notes. 2017;10(1):32.CrossRef
8.
go back to reference Thapa A, Pant MN. Metoclopramide and acute dystonia: a case report. J Gen Pract Emerg Med Nepal. 2019;6(8):40–2. Thapa A, Pant MN. Metoclopramide and acute dystonia: a case report. J Gen Pract Emerg Med Nepal. 2019;6(8):40–2.
9.
go back to reference Arumugam J, Vijayalakshmi AM. Metoclopramide-induced oculogyric crises presenting as encephalitis in a young girl. Indian J Pharmacol. 2012;44(2):266–7.CrossRef Arumugam J, Vijayalakshmi AM. Metoclopramide-induced oculogyric crises presenting as encephalitis in a young girl. Indian J Pharmacol. 2012;44(2):266–7.CrossRef
10.
go back to reference Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239–45.CrossRef Naranjo CA, Busto U, Sellers EM, et al. A method for estimating the probability of adverse drug reactions. Clin Pharmacol Ther. 1981;30(2):239–45.CrossRef
11.
go back to reference Ganzini L, Casey DE, Hoffman WF, McCall AL. The prevalence of metoclopramide-induced tardive dyskinesia and acute extrapyramidal movement disorders. Arch Intern Med. 1993;153(12):1469–75.CrossRef Ganzini L, Casey DE, Hoffman WF, McCall AL. The prevalence of metoclopramide-induced tardive dyskinesia and acute extrapyramidal movement disorders. Arch Intern Med. 1993;153(12):1469–75.CrossRef
12.
go back to reference Leus M, van de Ven A. An acute dystonic reaction after treatment with metoclopramide. N Engl J Med. 2015;373(14): e16.CrossRef Leus M, van de Ven A. An acute dystonic reaction after treatment with metoclopramide. N Engl J Med. 2015;373(14): e16.CrossRef
13.
go back to reference Freudenreich O. Atypical laryngeal dystonia caused by an antiemetic. Am Fam Physician. 2004;69(7):1623.PubMed Freudenreich O. Atypical laryngeal dystonia caused by an antiemetic. Am Fam Physician. 2004;69(7):1623.PubMed
14.
go back to reference Dubow JS, Leikin J, Rezak M. Acute chorea associated with metoclopramide use. Am J Ther. 2006;13(6):543–4.CrossRef Dubow JS, Leikin J, Rezak M. Acute chorea associated with metoclopramide use. Am J Ther. 2006;13(6):543–4.CrossRef
15.
go back to reference Weddington WW Jr, Banner A. Organic affective syndrome associated with metoclopramide: case report. J Clin Psychiatry. 1986;47(4):208–9.PubMed Weddington WW Jr, Banner A. Organic affective syndrome associated with metoclopramide: case report. J Clin Psychiatry. 1986;47(4):208–9.PubMed
16.
go back to reference Anfinson TJ. Akathisia, panic, agoraphobia, and major depression following brief exposure to metoclopramide. Psychopharmacol Bull. 2002;36(1):82–93.PubMed Anfinson TJ. Akathisia, panic, agoraphobia, and major depression following brief exposure to metoclopramide. Psychopharmacol Bull. 2002;36(1):82–93.PubMed
17.
go back to reference Akbuga-Ozel B, Aksel G, Kilicli E, Muratoglu M, Kavalci C, Gulalp B, et al. Metoclopramide-induced acute dystonic reaction misinterpreted as conversion disorder and seizure. Eur J Gen Med. 2017;14(4):122–4. Akbuga-Ozel B, Aksel G, Kilicli E, Muratoglu M, Kavalci C, Gulalp B, et al. Metoclopramide-induced acute dystonic reaction misinterpreted as conversion disorder and seizure. Eur J Gen Med. 2017;14(4):122–4.
18.
go back to reference Campbell D. The management of acute dystonic reactions. Aust Prescr. 2001;24:19–20.CrossRef Campbell D. The management of acute dystonic reactions. Aust Prescr. 2001;24:19–20.CrossRef
19.
go back to reference van Harten PN, Hoek HW, Kahn RS. Acute dystonia induced by drug treatment. BMJ. 1999;319(7210):623–6.CrossRef van Harten PN, Hoek HW, Kahn RS. Acute dystonia induced by drug treatment. BMJ. 1999;319(7210):623–6.CrossRef
20.
go back to reference Devaraj NK, Aneesa AR, Abdul Hadi AM, Shaira N. Topical corticosteroids in clinical practice. Med J Malays. 2019;74(2):187–9. Devaraj NK, Aneesa AR, Abdul Hadi AM, Shaira N. Topical corticosteroids in clinical practice. Med J Malays. 2019;74(2):187–9.
Metadata
Title
Metoclopramide-induced acute dystonic reactions: a case report
Authors
Ritesh Chaudhary
Gyanendra Malla
Monika Kadayat
Publication date
01-12-2021
Publisher
BioMed Central
Published in
Journal of Medical Case Reports / Issue 1/2021
Electronic ISSN: 1752-1947
DOI
https://doi.org/10.1186/s13256-021-03110-y

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