Acute Dystonic Reaction in a 14-Year-Old Boy after Accidental Overuse of Nasal Metoclopramide

Abstract

We present the case of a 14-year-old boy who developed an acute dystonic reaction 5 h following the overuse of a nasal metoclopramide spray that his mother gave him thinking it was a nasal decongestant. The patient had torticollis and intense motor restlessness, while he was fully conscious and hemodynamically stable. All laboratory investigations were normal. He was treated with a single dose of biperiden intravenously with direct disappearance of the symptoms. Children are particularly susceptible to the extrapyramidal side effects of metoclopramide that can occur irrespective of the route of administration.