Metoclopramide-Induced Oculogygyric Crisis: Report of Three Cases

Abstract

Metoclopramide is a dopamine (D2) receptor blocker, which is widely used in emergency departments (EDs) in the treatment of patients with nausea and emesis. The primary side effect is acute extrapyramidal reactions requiring acute intervention. Acute dystonic reaction incidence is 0.5-1% in children while incidence in young adults and elders is 25%. Oculogyric crisis is an acute dystonic reaction of the ocular muscles characterized by bilateral dystonic elevation of visual gaze lasting from seconds to hours. There have been few published cases on oculogyric crisis in general. This reaction is most commonly explained as an adverse reaction to drugs such as antiemetics, antipsychotics, antidepressants, antiepileptics, and antimalarials. It is important to be able to recognize this ocular side effect because, without a thorough patient history, symptoms can be confused with other diseases (such as versive seizures, encephalopathy). In this paper, we report three cases of oculogyric crisis induced by metoclopramide.