Probable dystonic reaction after a single dose of cyclizine in a patient with a history of encephalitis.

Author(s): King H, Corry P, Wauchob T, Barclay P

Affiliation(s): Liverpool Women's Hospital, Crown Street, Liverpool L8 7SS, UK.

Publication date & source: 2003-03, Anaesthesia., 58(3):257-60.

Publication type: Case Reports

A patient underwent an emergency Caesarean section under general anaesthesia for an antepartum haemorrhage. Following delivery of a live infant, cyclizine was administered in accordance with departmental anti-emetic protocol. On awakening she was confused, slow to articulate and had slurred speech. A computed tomography (CT) scan, which was performed to exclude an intracranial event, was normal. Her symptoms were suggestive of a lingual-facial-buccal dyskinesia as seen with dopamine antagonists. A presumptive diagnosis of a dystonic reaction to cyclizine was made. She received two doses of procyclidine before her symptoms completely resolved. Cyclizine has had a resurgence in popularity owing to the recent withdrawal of droperidol and anaesthetists should be aware that, although extremely rare, dystonic reactions may occur with this agent.