Dystonic reaction to a phenothiazine presenting as Bell's palsy.
An 11-year-old boy presented to the pediatric ED with signs and symptoms of Bell's palsy, which was believed to be a result of otitis media. He subsequently began to list to the left and could not walk erect. Because of a history of prochlorperazine use for vomiting, a diagnosis of a dystonic reaction to a phenothiazine was made, and the patient was treated with intravenous diphenhydramine. All symptoms resolved, including seventh nerve palsy, within 5 minutes of treatment. Medications are often prescribed by physicians for vomiting without caretakers being aware of the side-effects. Dystonic reactions can be severe and present with myriad neurologic signs and symptoms.
Bhopale
S
S
Department of Emergency Medicine, Harbor-UCLA Medical Center, Los Angeles, CA, USA.
Seidel
J S
JS
D000932:Antiemetics / Q000009:adverse effects*; D002648:Child; D002746:Chlorpromazine / Q000009:adverse effects*; D003937:Diagnosis, Differential; D004421:Dystonia / Q000139:chemically induced* / Q000175:diagnosis*; D005158:Facial Paralysis / Q000139:chemically induced / Q000175:diagnosis; D006801:Humans; D008297:Male; D014839:Vomiting / Q000188:drug therapy
D000932:Antiemetics; D002746:Chlorpromazine