甲氧氯丙胺引起的急性肌张力障碍误诊为狼疮患者癫痫发作。

Journal of epilepsy research Pub Date : 2021-12-31 eCollection Date: 2021-12-01 DOI:10.14581/jer.21025
Airenakho Emorinken, Oluwaseun Remi Agbadaola
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引用次数: 1

摘要

急性张力障碍反应是与甲氧氯普胺相关的最常见的锥体外系不良反应。它可能被误认为各种其他疾病,如癫痫、破伤风和脑炎,仅举几个可能性。我们提出一个病例26岁的女性被误诊为癫痫发作谁是匆忙到急诊室与不自主的双侧上偏的眼睛,痉挛,僵硬,颈部外侧偏,和舌头突出。症状发生在转介医院用于治疗恶心和呕吐的甲氧氯普胺开始使用36小时后。所有的实验室工作都很正常。停用该药,静脉注射双哌啶5毫克。症状约10分钟消退,无复发。甲氧氯丙胺引起的急性肌张力障碍不仅给患者造成焦虑的环境,而且可能危及生命。由于误诊的可能性高,详细的用药史和高怀疑指数是做出正确诊断的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Metoclopramide-induced Acute Dystonia Misdiagnosed as an Epileptic Seizure in a Lupus Patient.

Acute dystonic reactions are the most prevalent extrapyramidal adverse effects associated with metoclopramide. It could be mistaken for a variety of other conditions, such as seizures, tetanus, and encephalitis, to name a few possibilities. We present a case of a 26-year-old female misdiagnosed as having an epileptic seizure who was rushed to the emergency unit with an involuntary bilateral upward deviation of the eyes, spasm, stiffness, lateral deviation of the neck, and protrusion of the tongue. Symptoms occurred 36 hours after the commencement of metoclopramide, used to treat nausea and vomiting in the referring hospital. All the laboratory work was normal. The drug was discontinued and 5 mg of intravenous biperiden was administered. The symptoms subsided in about 10 minutes with no recurrence. Metoclopramide-induced acute dystonia not only creates an anxious environment for patients but may also be life-threatening. Due to the high probability of misdiagnosis, detailed drug history and a high index of suspicion are critical in making the correct diagnosis.

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