Recurrent Temporomandibular Joint Dislocation Due to Antiemetic Induced Acute Dystonia: A Case Report

Year 2022, Volume: 13 Issue: 2, 40 - 42, 23.06.2022

Nafis Vural , Emine Vural

https://doi.org/10.33706/jemcr.1015430

Cited By: 1

Abstract

Introduction: Drug-induced acute dystonic reaction is a common presentation to emergency department. Oromandibular dystonia is one of the focal dystonias, which can be presented as jaw clenching, jaw opening or jaw deviation and leads to impaired speech and swallowing. In this paper, we presented an adult patient with recurrent temporomandibular joint dislocation due to metoclopramide use.
Case Report: A 21-year-old female patient came to the emergency department with the complaints of inability chew and swallow, difficulty in speaking, pain at right temporomandibular region that started a few hours ago. On physical examination, she was having dystonia of the right mandibular region and left posterior servikal region and no dystonia at other parts of the body. The patient was diagnosed with metoclopramide-induced acute dystonia. She was treated with intravenous anticholinergic.
Conclusion: Metoclopramide is an antiemetic drug that can cause serious adverse events such as acute dystonic reaction. Among these side effects are oromandibular dystonias, which may lead to TMJ dislocation. Physicians and other healthcare professionals working in the emergency department should be familiar with such side effects.

Keywords

Temporomandibular joint dislocation, dystonia, metoclopramide, emergency department

References

• 1. Albanese A, Bhatia K, Bressman SB, Delong MR, Fahn S, Fung VSC, et al. Phenomenology and classification of dystonia: A consensus update [Internet]. Vol. 28, Movement Disorders. John Wiley & Sons, Ltd; 2013 [cited 2021 Oct 7]. p. 863–73. Available from: https://onlinelibrary.wiley.com/doi/full/10.1002/mds.25475
• 2. Karthik MS, Prabhu N. Temporomandibular joint dislocation due to atypical antipsychotic-induced acute dystonia: A case report [Internet]. Vol. 4, Therapeutic Advances in Psychopharmacology. SAGE Publications; 2014 [cited 2021 Oct 7]. p. 282–4. Available from: /pmc/articles/PMC4257988/
• 3. Solberg M, Koht J. Dystonia induced by drug treatment. Tidsskr Den Nor legeforening [Internet]. 2016 Nov 8 [cited 2021 Oct 7];136(20):1730. Available from: https://tidsskriftet.no/en/2016/11/dystonia-induced-drug-treatment
• 4. Burke RE, Fahn S, Jankovic J, Marsden CD, Lang AE, Gollomp S, et al. Tardive dystonia: Late-onset and persistent dystonia caused by antipsychotic drugs. Neurology [Internet]. 1982 [cited 2021 Oct 7];32(12):1335–46. Available from: https://pubmed.ncbi.nlm.nih.gov/6128697/
• 5. Miller LG, Jankovic J. Metoclopramide-induced movement disorders. Clinical findings with a review of the literature [Internet]. Vol. 149, Archives of Internal Medicine. Arch Intern Med; 1989 [cited 2021 Oct 7]. p. 2486–92. Available from: https://pubmed.ncbi.nlm.nih.gov/2684075/
• 6. Karagoz G, Kadanali A, Dede B, Anadol U, Yucel M, Bektasoglu MF. Metoclopramide-Induced Acute Dystonic Reaction: A Case Report. Eurasian J Med [Internet]. 2013 Feb [cited 2021 Oct 7];45(1):58. Available from: /pmc/articles/PMC4261495/
• 7. Hagen EM, Farbu E, Bindoff L. [Acute dystonia caused by metoclopramide (Afipran) therapy]. Tidsskr Nor Laegeforen [Internet]. 2001/09/27. 2001;121(18):2162–3. Available from: http://www.ncbi.nlm.nih.gov/pubmed/11571992
• 8. Eken C, Güler V, Koparan C, Çicek M. Temporomandibular joint dislocation due to haloperidol induced acute dystonia: A case report and review of the literature. Erciyes Tip Derg. 2009;31(SUPPL. 1):10–4.
• 9. El Ç, Çelikkaya ME. Varied clinical presentations of acute dystonic reaction due to metoclopramide. Pediatr Emerg Care [Internet]. 2019 May 1 [cited 2021 Oct 7];35(5):369–72. Available from: https://journals.lww.com/pec-online/Fulltext/2019/05000/Varied_Clinical_Presentations_of_Acute_Dystonic.10.aspx
• 10. Tianyi F-L, Agbor VN, Njim T. Metoclopramide induced acute dystonic reaction: a case report. BMC Res Notes 2017 101 [Internet]. 2017 Jan 7 [cited 2021 Oct 24];10(1):1–3. Available from: https://bmcresnotes.biomedcentral.com/articles/10.1186/s13104-016-2342-6
• 11. Oyewole A, Adelufosi A, Abayomi O. Acute Dystonic Reaction as Medical Emergency: A Report of Two Cases. Ann Med Health Sci Res [Internet]. 2013 [cited 2021 Oct 24];3(3):453. Available from: /pmc/articles/PMC3793459/
• 12. Lavonas Eric J. First-generation (typical) antipsychotic medication poisoning - UpToDate. 2018 [cited 2021 Oct 24];1–25. Available from: https://www.uptodate.com/contents/first-generation-typical-antipsychotic-medication-poisoning?search=extrapyramidal symptoms&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1#H13
• 13. Munhoz RP, Moscovich M, Araujo PD, Teive HAG. Movement disorders emergencies: A review [Internet]. Vol. 70, Arquivos de Neuro-Psiquiatria. Arq Neuropsiquiatr; 2012 [cited 2021 Oct 25]. p. 453–61. Available from: https://pubmed.ncbi.nlm.nih.gov/22699544/