eMedicine Specialties > Emergency Medicine > Toxicology

Toxicity, Medication-Induced Dystonic Reactions: Differential Diagnoses & Workup

Author: Geofrey Nochimson, MD, Consulting Staff, Department of Emergency Medicine, Sentara Careplex Hospital
Contributor Information and Disclosures

Updated: Sep 30, 2008

Differential Diagnoses

Conversion Disorder
Stroke, Ischemic
Dislocations, Mandible
Tetanus
Hypocalcemia
Toxicity, Anticholinergic
Hypomagnesemia
Toxicity, Carbamazepine
Meningitis
Toxicity, Phenytoin
Status Epilepticus
Toxicity, Valproate
Stroke, Hemorrhagic

Other Problems to Be Considered

Metabolic or respiratory alkalosis
Toxicity, strychnine
Oropharyngeal infections

More on Toxicity, Medication-Induced Dystonic Reactions

Overview: Toxicity, Medication-Induced Dystonic Reactions
Differential Diagnoses & Workup: Toxicity, Medication-Induced Dystonic Reactions
Treatment & Medication: Toxicity, Medication-Induced Dystonic Reactions
Follow-up: Toxicity, Medication-Induced Dystonic Reactions
References

References

  1. Barach E, Dubin LM, Tomlanovich MC, Kottamasu S. Dystonia presenting as upper airway obstruction. J Emerg Med. May-Jun 1989;7(3):237-40. [Medline].

  2. Demetropoulos S, Schauben JL. Acute dystonic reactions from "street Valium". J Emerg Med. Jul-Aug 1987;5(4):293-7. [Medline].

  3. Elliott ES, Marken PA, Ruehter VL. Clozapine-associated extrapyramidal reaction. Ann Pharmacother. May 2000;34(5):615-8. [Medline].

  4. Fahn S. The varied clinical expressions of dystonia. Neurol Clin. Aug 1984;2(3):541-54. [Medline].

  5. Fines RE, Brady WJ, DeBehnke DJ. Cocaine-associated dystonic reaction. Am J Emerg Med. Sep 1997;15(5):513-5. [Medline].

  6. Herrstedt J. Risk-benefit of antiemetics in prevention and treatment of chemotherapy-induced nausea and vomiting. Expert Opin Drug Saf. May 2004;3(3):231-48. [Medline].

  7. Jhee SS, Zarotsky V, Mohaupt SM, et al. Delayed onset of oculogyric crisis and torticollis with intramuscular haloperidol. Ann Pharmacother. Oct 2003;37(10):1434-7. [Medline].

  8. Kumor K. Cocaine withdrawal dystonia. Neurology. May 1990;40(5):863-4. [Medline].

  9. Marsden CD, Jenner P. The pathophysiology of extrapyramidal side-effects of neuroleptic drugs. Psychol Med. Feb 1980;10(1):55-72. [Medline].

  10. McCormick MA, Manoguerra AS. Dystonic reaction. In: Harwood-Nuss A, et al, eds. Clinical Practice of Emergency Medicine. Lippincott Williams & Wilkins; 1991:510-511.

  11. Piecuch S, Thomas U, Shah BR. Acute dystonic reactions that fail to respond to diphenhydramine: think of PCP. J Emerg Med. May-Jun 1999;17(3):527. [Medline].

  12. Roberge RJ. Antiemetic-related dystonic reaction unmasked by removal of a scopolamine transdermal patch. J Emerg Med. Apr 2006;30(3):299-302. [Medline].

  13. Schumock GT, Martinez E. Acute oculogyric crisis after administration of prochlorperazine. South Med J. Mar 1991;84(3):407-8. [Medline].

Further Reading

Keywords

medication-induced dystonic reactions, dystonic reaction, neuroleptic drug therapy, drug treatment, neuroleptics, neuroleptic agents, dyskinesia, acute dystonic reaction, neuroleptic drugs, involuntary muscle contractions

Contributor Information and Disclosures

Author

Geofrey Nochimson, MD, Consulting Staff, Department of Emergency Medicine, Sentara Careplex Hospital
Geofrey Nochimson, MD is a member of the following medical societies: American College of Emergency Physicians
Disclosure: Nothing to disclose.

Medical Editor

Samuel M Keim, MD, Associate Professor, Department of Emergency Medicine, University of Arizona College of Medicine
Samuel M Keim, MD is a member of the following medical societies: American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Public Health Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Michael J Burns, MD, Instructor, Department of Emergency Medicine, Harvard University Medical School, Beth Israel Deaconess Medical Center
Michael J Burns, MD is a member of the following medical societies: American Academy of Clinical Toxicology, American College of Emergency Physicians, American College of Medical Toxicology, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

John D Halamka, MD, MS, Associate Professor of Medicine, Harvard Medical School, Beth Israel Deaconess Medical Center; Chief Information Officer, CareGroup Healthcare System and Harvard Medical School; Attending Physician, Division of Emergency Medicine, Beth Israel Deaconess Medical Center
John D Halamka, MD, MS is a member of the following medical societies: American College of Emergency Physicians, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Chief Editor

Asim Tarabar, MD, Assistant Professor, Department of Surgery, Section of Emergency Medicine, Yale University School of Medicine; Consulting Staff, Department of Emergency Medicine, Yale-New Haven Hospital
Disclosure: Nothing to disclose.

 
 
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