Acute paraparesis due to terbutaline sulfate

A woman who was 30 weeks pregnant was given terbutaline sulfate to prevent premature labor contractions. Within several days, she had an acute paraparesis with myalgias and was unable to walk. Full neurologic investigation failed to show any obvious cause. Terbutaline therapy was discontinued, and in 48 hours she became asymptomatic. Terbutaline sulfate (Brethine) is a beta-adrenergic agonist that works on smooth muscle. Various theories about its effect on skeletal muscle have been published. The importance of this case report is to make physicians aware of the rare muscular side effects of terbutaline, and careful observation may obviate extensive and invasive testing.