Alkharboush GA, Alsalamah MA. In: Hoffman RS, Howland MA, Lewin NA, Nelson LS, Goldfrank LR, eds. as many as 1 in 3 patients experience at least a mild dystonic reaction in the first few days after starting an antipsychotic …
Clozapine-associated extrapyramidal reaction. Brady W, Hall K. Erythromycin-related dystonic reaction.
In dystonic cerebral palsy, treatment with larger doses of levodopa is associated with the development of potentially troublesome motor complications (including response fluctuations and dyskinesias). Geofrey Nochimson, MD is a member of the following medical societies:
Blood or urine tests. Jhee SS, Zarotsky V, Mohaupt SM, et al. 1991 Mar.
PMID: 25497845. Acute dystonic reactions that fail to respond to diphenhydramine: think of PCP.
2002 Drug-induced movement disorders in children at paediatric emergency department: 'dystonia'. Although a wide variety of medications can elicit symptoms, the typical antipsychotics are most often responsible. Schumock GT, Martinez E. Acute oculogyric crisis after administration of prochlorperazine. Antiemetic-related dystonic reaction unmasked by removal of a scopolamine transdermal patch.
Procedures A literature review by Hawthorne and Caley found among published reports of extrapyramidal reactions associated with serotonergic antidepressant therapy—not only dyskinesia but also akathisia, dyskinesia, parkinsonism, and mixed extrapyramidal reactions—that the reactions typically developed within 30 days of either the start of treatment or a dosage increase.Risk factors for drug-induced dystonic reactions include a family history of dystonia, a recent history of cocaine or alcohol use, or treatment with a potent dopamine D2 receptor antagonist (eg, fluphenazine, haloperidol).Obtain history from others if patient is not able to speak.Obtain medication history, including new medications and/or dosage increases.Physical examination findings may include any of the following:Oculogyric crisis - fixed deviation of the eyes in one directionTortipelvic crisis - Typically involves hip, pelvis, and abdominal wall muscles, causes difficulty with ambulationRemaining physical examination findings are normal.Neuroleptics (antipsychotics), antiemetics, and antidepressants are the most common causes of drug-induced dystonic reactions.Predisposing factors include a family history of dystonia and viral infection.Fahn S. The varied clinical expressions of dystonia.
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Dystonic reactions are reversible extrapyramidal effects that can occur after administration of a neuroleptic drug. Drug-induced movement disorders in children at paediatric …
Dystonic reactions most often occur shortly after initiation of drug treatment or an increase in drug dose; 50% occur within 48 hours of initiation of treatment, and 90% occur within 5 days. Elliott ES, Marken PA, Ruehter VL. Piecuch S, Thomas U, Shah BR. Demetropoulos S, Schauben JL.
In: Hoffman RS, Howland MA, Lewin NA, Nelson LS, Goldfrank LR, eds. 2002 All material on this website is protected by copyright, Copyright © 1994-2020 by WebMD LLC. Barach E, Dubin LM, Tomlanovich MC, Kottamasu S. Dystonia presenting as upper airway obstruction.
Tekin U, Soyata AZ, Oflaz S. Acute focal dystonic reaction after acute methylphenidate treatment in an adolescent patient.
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