Metoclopramide is the prokinetic antiemetic drug which acts by blocking central dopaminergic receptors and is known to cause extra pyramidal symptoms (EPS) especially dystonia. They occur in 1% of patients given metoclopramide as anti-emetic in the medical ward. This neurological case study is about a young male patient who received only one dose of IV metoclopramide and developed acute dystonia. Symptoms disappeared after one dose of 50 mg I.V promethazine was given. A neurological rating scale called as extra pyramidal symptoms rating scale (ESRS) was used to assess EPS. Acute dystonia poses a serious challenge in the medical ward due to more chances of misdiagnosis such as seizures or psychogenic disorder (hysteria), stroke, tetanus, meningitis etc.
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