title: Cocaine-associated dystonic reaction.
abstract: Dystonic reactions are extrapyramidal motor dysfunctions that result from an insufficient activity of nigrostriatal dopamine and present clinically as spasms of the various muscle groups. Neuroleptic drugs are a known cause of dystonia and are the most frequently encountered trigger. Cocaine use has been associated with dystonias, though much less often. When reported in the setting of a dystonic reaction, cocaine has been described as a predisposing factor for the patient already using neuroleptic agents. Fewer reports of dystonia as a direct result of cocaine use, independent of neuroleptics, are found in the literature. The cases of two acute dystonic reactions secondary to cocaine use are presented, with a discussion of the pathophysiology and treatment alternatives.
authors.affiliation: Department of Emergency Medicine, University of Virginia Health Sciences Center, Charlottesville 22908, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Fines
authors.forename: W J
authors.initials: WJ
authors.lastname: Brady
authors.forename: D J
authors.initials: DJ
authors.lastname: DeBehnke
mesh_terms: D000328:Adult; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003042:Cocaine / Q000506:poisoning*; D004155:Diphenhydramine / Q000627:therapeutic use; D004421:Dystonia / Q000139:chemically induced*; D004630:Emergencies; D006801:Humans; D008297:Male
chemical_list: D000978:Antiparkinson Agents; D004155:Diphenhydramine; D003042:Cocaine