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Ondansetron-induced multifocal encephalopathy

Matthew J Ritter1, Brent P Goodman, Juraj Sprung

  • 1Department of Anesthesiology, Mayo Clinic, Rochester, Minn. 55905, USA.

Mayo Clinic Proceedings
|September 10, 2003
PubMed

Insights

Ondansetron can cause temporary movement disorders, including dystonia and oculogyric crisis, in patients emerging from anesthesia. Awareness of this rare side effect is crucial for all medical professionals.

Area of Science:

  • Neuroscience
  • Pharmacology
  • Anesthesiology

Background:

  • Ondansetron is a widely used antiemetic.
  • Extrapyramidal symptoms are movement disorders that can have various causes.

Observation:

  • A patient developed multifocal encephalopathy with extrapyramidal symptoms (oromandibular dystonia, oculogyric crisis, limb dystonia) after ondansetron administration.
  • No other causative medications were given.

Findings:

  • The patient's symptoms were transient and resolved completely.
  • The presentation mimicked structural brain injury.

Implications:

  • Ondansetron may induce serious, albeit temporary, neurological adverse events.
  • Clinicians should consider ondansetron as a potential cause of extrapyramidal symptoms, even in the absence of other risk factors.
  • Increased awareness among healthcare providers is necessary to recognize and manage this adverse reaction.

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