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Posted On : 10 Jun 2009

What is primary acute dystonic reaction_? What are the presentations and how is it managed_?

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pediatriconcall

It is also known as OCULOGYRIC CRISIS. Oculogyric crisis {OGC} is the name of a dystonic reaction to certain drugs or medical conditions. Initial symptoms include incredible restlessness, agitation, malaise, or a fixed stare. Then comes the more characteristically described extreme and sustained upward deviation of the eyes. In addition, the eyes may converge, deviate upward and laterally, or deviate downward. The most frequently reported associated findings are backwards and lateral flexion of the neck, widely opened mouth, tongue protrusion, and ocular pain. However it may also be associated with intensely painful jaw spasm which may result in the breaking of a tooth. A wave of exhaustion may follow an episode. The abrupt termination of the psychiatric symptoms at the conclusion of the crisis is most striking. Immediate treatment of drug induced OGC can be achieved with intravenous antimuscarinic benztropine or procyclidine` which usually are effective within 5 minutes, although may take as long as 30 minutes for full effect. Further doses of procyclidine may be needed after 20 minutes. Any causative new medication should be discontinued. Also can be treated with 25 mg diphenhydramine

15 years ago

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