Case Report
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Oromandibular Distonide Yeniden İlaç Başlamak Bir Risk Faktörü müdür? Haloperidol Sonrası Görülen Nadir Bir Olgu Sunumu

Year 2022, Volume: 6 Issue: 1, 125 - 127, 28.04.2022
https://doi.org/10.29058/mjwbs.1030462

Abstract

Amaç: Haloperidol yaygın kullanılan antipsikotik bir ilaçtır. Antipsikotik ilaçların yan etkisi olan
ekstrapiramidal semptomlar haloperidol kullanımında da yaygın görülmektedir. Oromandibular distoni
bu ekstrapiramidal etkiler arasında olup daha az görülmektedir. Ekstrapiramidal etkilerin ilacın yeniden
başlanmasından sonra artıp artmayacağı vaka raporları ile bildirilmiş olup, bu konudaki bilgiler sınırlıdır.
Bu yazıda, haloperidol tedavisini kesip tekrar başladıktan sonra oromandibular distoni gelişen bir olgu
sunulmaktadır.
Olgu: Otuz yaşında kadın hasta dilde istemsiz hareketler, peltek konuşma ile acil servise başvurdu.
Hastanın 4 yıldır haloperidol kullandığı, son bir aydır bıraktığı ve son 3 gündür tekrar kullanmaya
başladığı öğrenildi. Fizik muayenesinde dilde hafif ödem, istemsiz dil çıkarma hareketleri not edildi.
Nörolojik muayenesinde distoni nedeniyle peltek konuşma haricinde patolojik bulguya rastlanmadı.
Ayırıcı tanıda yapılan kraniyal görüntülemeleri normal saptandı. Haloperidol kesilerek, intravenöz
feniramin tedavisi verildi. Acil serviste 5 saatlik gözlemin ardından tam iyileşme ile taburcu edildi.
Sonuç: Bizim vakamızda haloperidolü kesip tekrar başlamasından sonra distonik reaksiyon gelişmiş
olması dikkat çekicidir. Bunun hastanın özgeçmişindeki ilk distonik reaksiyon olması, ilacın yeniden
başlatılmasının ekstrapiramidal etkiler için bir risk faktörü olup olmadığı sorusunu akla getirmektedir. Bu
konuda yeni çalışmalara ihtiyaç vardır.

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Project Number

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Thanks

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References

  • 1. Lally J, MacCabe JH. Antipsychotic medication in schizophrenia: A review. Br Med Bull 2015;114(1):169-79.
  • 2. Shen YZ, Peng K, Zhang J, Meng XW, Ji FH. Effects of haloperidol on delirium in adult patients: A systematic review and meta-analysis. Med Princ Pract 2018;27(3):250-259.
  • 3. Snaith A, Wade D. Dystonia. BMJ Clin Evid 2014;2014:1211.
  • 4. Albanese A, Bhatia K, Bressman SB, Delong MR, Fahn S, Fung VS, Hallett M, Jankovic J, Jinnah HA, Klein C, Lang AE, Mink JW, Teller JK. Phenomenology and classification of dystonia: A consensus update. Mov Disord 2013;28(7):863-873.
  • 5. Lee KH. Oromandibular dystonia. Oral Surg Oral Med Oral Radiol Endod 2007;104(4):491-496.
  • 6. Miodownik C, Vladimir Lerner MD, Witztum E. Pisa syndrome and laryngeal dystonia induced by novel antipsychotics. Isr J Psychiatry Relat Sci 2011;48:195-200.
  • 7. Fabbrini G, Defazio G, Colosimo C, Thompson PD, Berardelli A. Cranial movement disorders: Clinical features, pathophysiology, differential diagnosis and treatment. Nat Clin Pract Neurol 2009;5(2):93-105.
  • 8. Munhoz RP, Moscovich M, Araujo PD, Teive HA. Movement disorders emergencies: A review. Arq Neuropsiquiatr 2012;70(6):453-461.
  • 9. Harten PN, Hoek HW, Kahn RS. Acute dystonia induced by drug treatment. BMJ 1999; 319(7210):623-626.
  • 10. Loonen AJ, Ivanova SA. Neurobiological mechanisms associated with antipsychotic drug-induced dystonia. J Psychopharmacol 2021;35(1):3-14.
  • 11. Lester DB, Rogers TD, Blaha CD. Acetylcholine-dopamine interactions in the pathophysiology and treatment of CNS disorders. CNS Neurosci Ther 2010;16:137-162.
  • 12. Blanchet PJ. Antipsychotic drug-induced movement disorders. Can J Neurol Sci 2003;30 Suppl 1:S101-107.
  • 13. Raoofi S, Khorshidi H, Najafi M. Etiology, diagnosis and management of oromandibular dystonia: An update for stomatologists. J Dent (Shiraz) 2017;18(2):73-81.
  • 14. Caroff SN, Hurford I, Lybrand J, Campbell EC. Movement disorders induced by antipsychotic drugs: Implications of the CATIE schizophrenia trial. Neurol Clin 2011;29(1):127-148.

Could Restart of Drug be a Risk Factor in Oromandibular Dystonia? A Rare Case Report Secondary to Haloperidol

Year 2022, Volume: 6 Issue: 1, 125 - 127, 28.04.2022
https://doi.org/10.29058/mjwbs.1030462

Abstract

Aim: Haloperidol is an antipsychotic drug which is widely used. In haloperidol use, extrapyramidal
symptoms, the side effects of antipsychotic drugs, are common. Oromandibular dystonia is a less
common form of these. Information on whether extrapyramidal side effects will increase after restart
of the drug is limited to case reports. In this article, we present a case of oromandibular dystonia,
which developed after restart of haloperidol therapy despite the use of biperiden for extrapyramidal side
effects.
Case: A 30-year-old female patient was presented to the emergency department with involuntary
tongue movements and slurred speech. It was learned that she had been using haloperidol for four
years but stopped it a month ago and started again 3 days ago. In the physical examination, mild edema
of the tongue and involuntary tongue movements were noted. Her neurological examination and cranial
imaging were completely normal. Haloperidol was discontinued. We have been given intravenous
pheniramine therapy and discharged with full recovery after 5 hours of observation in the emergency
room.
Conclusion: In our case, it is noteworthy that dystonia developed after she had restarted haloperidol. The fact that this was the first dystonic
reaction experienced by the patient suggests the question of whether restarting of the drug is a risk factor for extrapyramidal effects. More
research is needed on this subject.

Project Number

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References

  • 1. Lally J, MacCabe JH. Antipsychotic medication in schizophrenia: A review. Br Med Bull 2015;114(1):169-79.
  • 2. Shen YZ, Peng K, Zhang J, Meng XW, Ji FH. Effects of haloperidol on delirium in adult patients: A systematic review and meta-analysis. Med Princ Pract 2018;27(3):250-259.
  • 3. Snaith A, Wade D. Dystonia. BMJ Clin Evid 2014;2014:1211.
  • 4. Albanese A, Bhatia K, Bressman SB, Delong MR, Fahn S, Fung VS, Hallett M, Jankovic J, Jinnah HA, Klein C, Lang AE, Mink JW, Teller JK. Phenomenology and classification of dystonia: A consensus update. Mov Disord 2013;28(7):863-873.
  • 5. Lee KH. Oromandibular dystonia. Oral Surg Oral Med Oral Radiol Endod 2007;104(4):491-496.
  • 6. Miodownik C, Vladimir Lerner MD, Witztum E. Pisa syndrome and laryngeal dystonia induced by novel antipsychotics. Isr J Psychiatry Relat Sci 2011;48:195-200.
  • 7. Fabbrini G, Defazio G, Colosimo C, Thompson PD, Berardelli A. Cranial movement disorders: Clinical features, pathophysiology, differential diagnosis and treatment. Nat Clin Pract Neurol 2009;5(2):93-105.
  • 8. Munhoz RP, Moscovich M, Araujo PD, Teive HA. Movement disorders emergencies: A review. Arq Neuropsiquiatr 2012;70(6):453-461.
  • 9. Harten PN, Hoek HW, Kahn RS. Acute dystonia induced by drug treatment. BMJ 1999; 319(7210):623-626.
  • 10. Loonen AJ, Ivanova SA. Neurobiological mechanisms associated with antipsychotic drug-induced dystonia. J Psychopharmacol 2021;35(1):3-14.
  • 11. Lester DB, Rogers TD, Blaha CD. Acetylcholine-dopamine interactions in the pathophysiology and treatment of CNS disorders. CNS Neurosci Ther 2010;16:137-162.
  • 12. Blanchet PJ. Antipsychotic drug-induced movement disorders. Can J Neurol Sci 2003;30 Suppl 1:S101-107.
  • 13. Raoofi S, Khorshidi H, Najafi M. Etiology, diagnosis and management of oromandibular dystonia: An update for stomatologists. J Dent (Shiraz) 2017;18(2):73-81.
  • 14. Caroff SN, Hurford I, Lybrand J, Campbell EC. Movement disorders induced by antipsychotic drugs: Implications of the CATIE schizophrenia trial. Neurol Clin 2011;29(1):127-148.
There are 14 citations in total.

Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Case Report
Authors

Cemrenur Uygun 0000-0002-3780-6660

Enis Ademoğlu 0000-0002-6330-666X

Mehmet Muzaffer İslam 0000-0001-6928-2307

Serkan Emre Eroğlu 0000-0002-3183-3713

Project Number -
Publication Date April 28, 2022
Acceptance Date February 19, 2022
Published in Issue Year 2022 Volume: 6 Issue: 1

Cite

Vancouver Uygun C, Ademoğlu E, İslam MM, Eroğlu SE. Oromandibular Distonide Yeniden İlaç Başlamak Bir Risk Faktörü müdür? Haloperidol Sonrası Görülen Nadir Bir Olgu Sunumu. Med J West Black Sea. 2022;6(1):125-7.

Medical Journal of Western Black Sea is a scientific publication of Zonguldak Bulent Ecevit University Faculty of Medicine.

This is a refereed journal, which aims at achieving free knowledge to the national and international organizations and individuals related to medical sciences in publishedand electronic forms.

This journal is published three annually in April, August and December.
The publication language of the journal is Turkish and English.