Case Report

A Case of Metoclopramide-induced Oculogyric Crisis in a 16-year-old Girl with Cystic Fibrosis

Authors: Emil Lou, MD, PHD, Nuhad Abou-Zeid, MD

Abstract

Oculogyric crisis is a neurologic reaction characterized by bilateral dystonic elevation of visual gaze as well as hyperextension of the neck. This reaction is most commonly explained as an adverse effect of numerous medications, such as dopamine receptor blocking agents or neuroleptic medications and traditional antipsychotic or antiemetic drugs, such as prochlorperazine or metoclopramide. A case of oculogyric crisis induced by metoclopramide is described in this paper.


Key Points


* Oculogyric crisis is a neurologic reaction which manifests as a dystonia which can be induced by various classes of medications.


* Metoclopramide is an example of one such medication which can lead to oculogyric crisis.


* Dystonia resulting from metoclopramide can be rapidly reversed by diphenhydramine.

This content is limited to qualifying members.

Existing members, please login first

If you have an existing account please login now to access this article or view purchase options.

Purchase only this article ($25)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.

References

1. Fraunfelder FW, Fraunfelder FT. Adverse ocular drug reactions recently identified by the National Registry of Drug-Induced Ocular Side Effects. Ophthalmology 2004;111:1275–1279.
 
2. Schumock GT, Martinez E. Acute oculogyric crisis after administration of prochlorperazine. South Med J 1991;84:407–408.
 
3. Skorin L Jr, Onofrey BE, DeWitt JD, Phenothiazine-induced oculogyric crisis. J Am Optom Assoc1987;58:316–318.
 
4. Jhee SS, Zarotsky V, Mohaupt SM, et al. Delayed onset of oculogyric crisis and torticollis with intramuscular haloperidol. Ann Pharmacother 2003;37:1434–1437.
 
5. Gorman M, Barkley GL. Oculogyric crisis induced by carbamazepine. Epilepsia 1995;36:1158–1160.
 
6. Edwards M, Koo MW, Tse RK. Oculogyric crisis after metoclopramide therapy. Optom Vis Sci1989;66:179–180.
 
7. Faura A, Canet J, Gallart L. [Oculogyric crisis associated with the use of metoclopramide]. Rev Esp Anestesiol Reanim 1990;37:185–186.
 
8. Berkman N, Frossard C, Moury F. [Oculogyric crisis and metoclopramide]. Bull Soc Ophtalmol Fr1981;81:153–155.
 
9. Cezard C, Nisse P, Quaranta S, et al. [Acute dystonia from metoclopramide in children]. Therapie2003;58:367–370.
 
10. Bumpass ER, Knoll JL III. Emotional factors in oculogyric crisis. J Nerv Ment Dis 1982;170:366–370.