title: Out-of-hospital lingual dystonia resulting in airway obstruction.
abstract: This article discusses a case of antipsychotic-induced, focal lingual dystonia causing airway obstruction that was managed completely in the out-of-hospital environment by emergency medical services (EMS) providers. With the ever-increasing use of antipsychotic medications by the general population, it is important for EMS providers and emergency medicine physicians to be aware of rare presentations of dystonic reactions that can sometimes be life-threatening when they involve the lingual, pharyngeal, or laryngeal musculature. This article identifies the medications most likely to induce dystonic reactions, risk factors that predispose individuals to the development of dystonia, and the pathophysiology behind these adverse reactions. It also discusses differential diagnoses to consider, and emergent treatment options.
authors.affiliation: Emergency Department, Truman Medical Center, Kansas City, Missouri 64108, USA. ryan.jacobsen@tmcmed.org
authors.forename: Ryan C
authors.initials: RC
authors.lastname: Jacobsen
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D000420:Albuterol / Q000008:administration & dosage* / Q000627:therapeutic use; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000627:therapeutic use; D003937:Diagnosis, Differential; D004155:Diphenhydramine / Q000008:administration & dosage* / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D020821:Dystonic Disorders / Q000139:chemically induced* / Q000175:diagnosis / Q000628:therapy; D004632:Emergency Medical Services / Q000379:methods; D006801:Humans; D009241:Ipratropium / Q000008:administration & dosage* / Q000627:therapeutic use; D008297:Male; D009330:Nebulizers and Vaporizers; D018967:Risperidone / Q000009:adverse effects* / Q000627:therapeutic use; D012563:Schizophrenia, Paranoid / Q000188:drug therapy; D013525:Surgical Instruments; D014059:Tongue / Q000187:drug effects / Q000503:physiopathology
chemical_list: D018926:Anti-Allergic Agents; D014150:Antipsychotic Agents; D001993:Bronchodilator Agents; D004155:Diphenhydramine; D009241:Ipratropium; D018967:Risperidone; D000420:Albuterol