Metoclopramide-induced parkinsonism in hemodialysis patients. Report of two cases.
Metoclopramide hydrochloride is an antiemetic and gastric motility stimulant with a wide variety of extrapyramidal side effects, including parkinsonism. We describe two patients with end-stage renal disease secondary to diabetes mellitus treated with hemodialysis who developed extrapyramidal symptoms during treatment with metoclopramide. One patient with preexisting, well-controlled Parkinson's disease developed increasing rigidity and bradykinesia that became completely refractory to treatment with L-dopa and bromocriptine while taking metoclopramide for diabetic gastroparesis. A second patient with no history of Parkinson's disease developed a resting tremor and facial dyskinesia during treatment with metoclopramide. In both cases, discontinuation of metoclopramide therapy led to prompt improvement of symptoms.
D000328:Adult; D000368:Aged; D003928:Diabetic Nephropathies / Q000628:therapy*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000628:therapy*; D008297:Male; D008787:Metoclopramide / Q000009:adverse effects* / Q000627:therapeutic use; D010302:Parkinson Disease, Secondary / Q000139:chemically induced*; D006435:Renal Dialysis; D014839:Vomiting / Q000517:prevention & control
D008787:Metoclopramide