[Acute dystonia from metoclopramide in children]

A retrospective study (1995-2000) of reports of cases of metoclopramide poisoning collected at the Lille poison control centre (184 phone calls) shows the frequent occurrence of acute dystonia in children (81 cases). These spectacular extrapyramidal symptoms consist of abnormal movements (31 cases), local hypertonia (30 cases), acute dyskinesia (17 cases), general hypertonia (16 cases) and oculogyric crisis (13 cases). There is no dose-effect correlation and sex has no influence on the occurrence of neurological symptoms. Medical management is simple surveillance or symptomatic therapy (a sedative drug and/or anti-parkinsonian therapy and/or a gastrointestinal adsorbent). Hospitalisation was needed in only 9.1% of cases. Providing better information to physicians about metoclopramide adverse effects and their medical management should allow a reduction in the number of unnecessary hospitalizations.