Session Information
Date: Tuesday, September 24, 2019
Session Title: Dystonia
Session Time: 1:45pm-3:15pm
Location: Les Muses Terrace, Level 3
Objective: A systematic review of patients treated in the emergency department of a tertiary referral hospital for acute dystonic reactions
Background: The dystonias are characterised by involuntary sustained muscle contractions that lead to forced positions. They may be due to dopaminergic receptor blocking. We describe a drug-induced dystonia case series
Method: Clinical characteristics of drug-induced dystonia patients attended in our hospital (2002-2018). Paediatric and levodopa-induced dystonia were excluded. Variables of interest included demographic, etiological, clinical variables and treatment response
Results: We included 77 patients; 53.2% were women, mean age 37.2±17.7. Segmental dystonia was the most frequent dystonia subtype (50.6%) followed by focal (40.3%) and generalised dystonia (9.1%). Cervical dystonia was the most common (51.9%), followed by oromandibular (50.6%), oculogyric crisis (23.4%), upper limbs (20.8%) and lower limbs (9.1%). Laringeal dystonia and blepharospasm were rather less common. The most frequent cause was dopaminergic receptor blockers (88.4%); antipsychotic drugs (44.2%) and antiemetic/antivertiginous drugs (44.2%). Tieliperazina was the most specific agent (15.6%), followed by Metoclopramida (13.0%), Risperidone (10.4%) and Haloperidol (9.1%). Exposure time was chronic (>1 month) in 27 patients (35.1%), subacute (1-week to 1-month) in 4 (5.2%) and acute in 46 (59.8%). Fifty-two patients (67.6%) were treated with biperiden, 6 (7.8%) with diazepam, while 5 (6.5%) with both. All treated cases improved completely. Untreated patients improved after drug withdrawal. Time to resolution was recorded in 49 patients (63.7%) (all less than 24 hours); 38 cases (49.4%) were asymptomatic in less than 1 hour
Conclusion: Dopaminergic receptor blockers were the most frequent cause of drug-induced dystonia. Clinical distribution is mainly cranial, but can be generalized. Benzodiazepines and anticholinergics are an effective treatment
To cite this abstract in AMA style:
JB. Paredes, V. Hristova, J. Poles, S. Madrona, P. Torre, I. Moreno, S. Argos, A. Canovas, JC. Castrillo, JL. Moreno. Drug-induced dystonia [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/drug-induced-dystonia/. Accessed June 15, 2025.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/drug-induced-dystonia/