Emergency: requires immediate attention
Drug-induced dystonia
Alerts and Notices
Synopsis
When acute dystonic reactions affect the neck region, difficulty swallowing, speaking, or breathing can ensue, which can be a medical emergency. Onset of acute dystonic reactions may occur within minutes or hours of drug intake, toxic exposure, or rapid dose increase, with most cases occurring within 5 days.
Drug-induced dystonia is most commonly caused by neuroleptics, especially high-potency neuroleptics, but also antiemetics. The pathophysiology is most often linked with blockage of dopamine receptors. Other risk factors for acute dystonia include young age, male sex, cocaine use, and history of acute dystonic reaction.
Related topics: Drug-induced movement disorders, Drug-induced muscle spasm
Codes
ICD10CM:G24.02 – Drug induced acute dystonia
G24.09 – Other drug induced dystonia
SNOMEDCT:
230315008 – Drug-induced dystonia
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Diagnostic Pearls
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Differential Diagnosis & Pitfalls
- Primary or genetic dystonia (eg, torsion dystonia, cervical dystonia)
- Stereotypies
- Tics / Tourette syndrome
- Wilson disease
- Huntington disease
- Neurodegeneration with brain iron accumulation (NBIA)
- Paroxysmal dyskinesia
- Muscle cramp or spasm
- Seizure
- Stroke
- Psychogenic events
Best Tests
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Management Pearls
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Therapy
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Drug Reaction Data
Below is a list of drugs with literature evidence indicating an adverse association with this diagnosis. The list is continually updated through ongoing research and new medication approvals. Click on Citations to sort by number of citations or click on Medication to sort the medications alphabetically.Subscription Required
References
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Last Reviewed:05/10/2018
Last Updated:05/10/2018
Last Updated:05/10/2018