Probable dystonic reaction after a single dose of cyclizine in a patient with a history of encephalitis.
A patient underwent an emergency Caesarean section under general anaesthesia for an antepartum haemorrhage. Following delivery of a live infant, cyclizine was administered in accordance with departmental anti-emetic protocol. On awakening she was confused, slow to articulate and had slurred speech. A computed tomography (CT) scan, which was performed to exclude an intracranial event, was normal. Her symptoms were suggestive of a lingual-facial-buccal dyskinesia as seen with dopamine antagonists. A presumptive diagnosis of a dystonic reaction to cyclizine was made. She received two doses of procyclidine before her symptoms completely resolved. Cyclizine has had a resurgence in popularity owing to the recent withdrawal of droperidol and anaesthetists should be aware that, although extremely rare, dystonic reactions may occur with this agent.
King
H
H
Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK.
Corry
P
P
Wauchob
T
T
Barclay
P
P
D000208:Acute Disease; D000328:Adult; D000768:Anesthesia, General / Q000379:methods; D000773:Anesthesia, Obstetrical / Q000379:methods; D000932:Antiemetics / Q000009:adverse effects*; D002585:Cesarean Section; D003501:Cyclizine / Q000009:adverse effects*; D004421:Dystonia / Q000139:chemically induced* / Q000188:drug therapy; D005260:Female; D006801:Humans; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D011247:Pregnancy; D011249:Pregnancy Complications, Cardiovascular / Q000601:surgery; D011352:Procyclidine / Q000627:therapeutic use; D014592:Uterine Hemorrhage / Q000601:surgery
D000932:Antiemetics; D018727:Muscarinic Antagonists; D011352:Procyclidine; D003501:Cyclizine