Toxicity, Medication-Induced Dystonic Reactions Treatment & Management
- Author: Geofrey Nochimson, MD; Chief Editor: Asim Tarabar, MD more...
Emergency Department Care
Emergency interventions other than pharmacologic treatment rarely are required.
Securing the airway is necessary only rarely, when laryngeal and pharyngeal dystonic reactions place the patient at risk of imminent respiratory arrest.
Pharmacologic treatment resolves the reaction.
Fahn S. The varied clinical expressions of dystonia. Neurol Clin. Aug 1984;2(3):541-54. [Medline].
Marsden CD, Jenner P. The pathophysiology of extrapyramidal side-effects of neuroleptic drugs. Psychol Med. Feb 1980;10(1):55-72. [Medline].
McCormick MA, Manoguerra AS. Dystonic reaction. In: Harwood-Nuss A, et al, eds. Clinical Practice of Emergency Medicine. Lippincott Williams & Wilkins; 1991:510-511.
Fines RE, Brady WJ, DeBehnke DJ. Cocaine-associated dystonic reaction. Am J Emerg Med. Sep 1997;15(5):513-5. [Medline].
Kumor K. Cocaine withdrawal dystonia. Neurology. May 1990;40(5):863-4. [Medline].
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].
Demetropoulos S, Schauben JL. Acute dystonic reactions from "street Valium". J Emerg Med. Jul-Aug 1987;5(4):293-7. [Medline].
Elliott ES, Marken PA, Ruehter VL. Clozapine-associated extrapyramidal reaction. Ann Pharmacother. May 2000;34(5):615-8. [Medline].
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].
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].
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].
Roberge RJ. Antiemetic-related dystonic reaction unmasked by removal of a scopolamine transdermal patch. J Emerg Med. Apr 2006;30(3):299-302. [Medline].
Schumock GT, Martinez E. Acute oculogyric crisis after administration of prochlorperazine. South Med J. Mar 1991;84(3):407-8. [Medline].

