Advertisement

Central European Journal of Medicine

, Volume 5, Issue 2, pp 224–226 | Cite as

Metoclopramide induced intermittent opisthotonos in infant

  • Necati Balamtekin
  • Mustafa Gulgun
  • S. Umit Sarici
  • Bulent Unay
  • M. Rusen Dundaroz
Case Report
  • 58 Downloads

Abstract

Metoclopramide is widely used as an antiemetic and a prokinetic agent. Both the antiemetic properties and side effects of the drug are the result of dopamine receptor antagonism within the central nervous system. Therapeutic doses of metoclopramide can produce adverse effects. A 5-month-old girl was referred to our emergency department with the pre-diagnosis of afebrile convulsion. In her medical history, she was mistakenly given 2 mg/kg metoclopramide within a 24 h period, after which she became hypertonic and exhibited intermittent opisthotonos. Complete blood count, electrolytes, liver and renal function tests, blood gas analysis, and urinalysis were all within normal limits. Electroencephalogram, brain CT and cerebrospinal fluid examination were normal. Metoclopramide treatment was discontinued and she was treated with biperiden, which led to an improvement in symptoms after 15 minutes and complete remission in 60 minutes. Intermittent opisthotonos may be confused with convulsion in infant and thus lead to an unnecessary hospital admission. Physicians should be aware that metoclopramide is widely used in the pediatric population and children are susceptible to the side effects of metoclopramide and the side effects may present as “intermittent opisthotonos” as observed in our patient.

Keywords

Intermittent Opisthotonos Infant Metoclopramide 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. [1]
    Cinquetti M., Bonetti P., Bertamini P., Current role of antidopaminergic drugs in pediatrics, Pediatr. Med. Chir., 2000, 22, 1–7PubMedGoogle Scholar
  2. [2]
    Keady S., Update on drugs for gastrooesophageal reflux disease, Arch. Dis. Child. Educ. Pract. Ed., 2007, 92, 114–118Google Scholar
  3. [3]
    Hyser C. L., Drake M. E. Jr., Myoclonus induced by metoclopramide therapy, Arch. Intern. Med., 1983, 143, 2201–2202CrossRefPubMedGoogle Scholar
  4. [4]
    Ceulemans B., van Rhijn J., Kenis S., Krols R., Laridon A., Havenbergh T. V., Ophisthotonus and intrathecal treatment with baclofen (ITB) in children, Eur. J. Pediatr., 2008, 167, 641–645CrossRefPubMedGoogle Scholar
  5. [5]
    Hibbs A. M., Lorch S. A., Metoclopramide for the treatment of gastroesophageal reflux disease in infants: a systematic review, Pediatrics, 2006, 118, 746–752CrossRefPubMedGoogle Scholar
  6. [6]
    Cezard C., Nisse P., Quaranta S., Peucelle D., Mathieu-Noolf M., Acute dystonia from metoclopramide in children, Therapie, 2003, 58, 367–370PubMedCrossRefGoogle Scholar
  7. [7]
    Bateman D. N., Craft A. W., Nicholson E., Pearson A. D., Dystonic reactions and the pharmatokinetics of metoclopramide in children, Br. J. Clin. Pharmacol., 1983, 15, 557–559PubMedGoogle Scholar
  8. [8]
    Crosley C. J., Swender P., Dystonia associated with carbamazepine administration: experince in brain damaged children, Pediatrics, 1979, 63, 612–615PubMedGoogle Scholar
  9. [9]
    Husain A., Chapel J., Malek-Ahmadi P., Methylphenidate, neuroleptics and dyskinesiadystonia, Can. J. Psychiatry, 1980, 25, 254–258PubMedGoogle Scholar
  10. [10]
    Holloman L. C., Marder S. R., Management of acute extrapyramidal effect induced by antipsychotic drugs, Am. J. Health. Syst. Pharm., 1997, 54, 2461–2477PubMedGoogle Scholar
  11. [11]
    Yis U., Özdemir D., Duman M., Ünal N., Metoclopramide induced dystonia in children: two case reports, Eur. J. Emerg. Med., 2005, 12, 117–119CrossRefPubMedGoogle Scholar

Copyright information

© © Versita Warsaw and Springer-Verlag Berlin Heidelberg 2009

Authors and Affiliations

  • Necati Balamtekin
    • 1
  • Mustafa Gulgun
    • 1
  • S. Umit Sarici
    • 2
  • Bulent Unay
    • 3
  • M. Rusen Dundaroz
    • 4
  1. 1.Faculty of Medicine, Department of PediatricsGulhane Military Medical AcademyAnkaraTurkey
  2. 2.Faculty of Medicine, Department of Pediatrics, Section of NewbornGulhane Military Medical AcademyAnkaraTurkey
  3. 3.Faculty of Medicine, Department of Pediatrics, Section of NeurologyGulhane Military Medical AcademyAnkaraTurkey
  4. 4.Faculty of Medicine, Department of Pediatrics, Section of Pediatric Emergency MedicineGulhane Military Medical AcademyAnkaraTurkey

Personalised recommendations