Dystonic reaction associated with ondansetron administration in a patient with normal pressure hydrocephalus.
A 77-year-old female with normal pressure hydrocephalus underwent urgent revision of the abdominal component of a ventriculoperitoneal shunt. Upon emergence from an uneventful general anesthetic, the patient exhibited cogwheel rigidity with decerebrate posturing and a markedly irregular respiratory rate. This prohibited extubation and prompted an unplanned intensive care unit admission. Ondansetron was the only medication administered that had previously been associated with dystonic reactions. In a previous procedure, the patient had been given ondansetron without a similar reaction. This presentation may have been provoked by existing pathology such as her underlying normal pressure hydrocephalus and small increases in intracranial pressure.
University of Iowa, Iowa City, IA. Electronic address: jay-diaz-parlet@uiowa.edu.
Jay
J
Diaz-Parlet
University of Iowa, Iowa City, IA. Electronic address: subhakar-subramani@uiowa.edu.
Sudhakar
S
Subramani
D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D004421:Dystonia / Q000139:chemically induced*; D005260:Female; D006801:Humans; D006850:Hydrocephalus, Normal Pressure / Q000150:complications / Q000601:surgery*; D007427:Intracranial Pressure / Q000502:physiology; D017294:Ondansetron / Q000009:adverse effects*; D012086:Reoperation; D017287:Ventriculoperitoneal Shunt / Q000379:methods*
D017294:Ondansetron