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Published on: November 21, 2013
Childhood dystonic reactions in the middle Black Sea region
1Ordu University, Faculty of Medicine, Department of Pediatrics, Division of Pediatric, Neurology, Ordu, Turkey.
Insights
Acute dystonic reactions in children are typically drug-induced and resolve quickly with prompt treatment. Early diagnosis and intervention with medications like biperiden are crucial for managing these neurological events.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Acute dystonic reactions are a significant cause of emergency department visits in children.
- Rapid diagnosis and treatment are essential for managing these neurological events.
Purpose of the Study:
- To investigate the clinical features, causes, and outcomes of acute dystonic reactions in pediatric patients.
- To analyze the effectiveness of treatment in a tertiary pediatric neurology setting.
Main Methods:
- Retrospective review of medical records for nine pediatric patients treated for acute dystonic reactions between May 2018 and May 2020.
- Data collected included age, gender, etiology, family history, treatment, and patient outcomes.
Main Results:
- All nine pediatric patients experienced drug-induced acute dystonic reactions, primarily from metoclopramide, risperidone, and aripiprazole.
- Intramuscular biperiden administration resulted in dramatic improvement within 30 minutes for all patients, with only one requiring an additional dose.
- All patients were discharged within 24 hours with no observed complications during follow-up.
Conclusions:
- Drug-induced acute dystonic reactions in children are diagnosable and fully reversible with effective treatment.
- Prompt administration of appropriate medication, such as biperiden, is key to successful management.
- While treatable, the potential for severe clinical manifestations necessitates timely intervention.
Abstract:
Acute dystonic reactions are a worrying reason for presentation to the pediatric emergency department and the pediatric neurology clinic in childhood. It must be diagnosed and treated quickly. The aim of this study was to examine the clinical presentations, etiological factors, and prognosis of patients presenting to our regional tertiary pediatric neurology clinic with a diagnosis of acute dystonic reactions in children.Nine pediatric patients who were treated for acute dystonic reactions between May, 2018 and May, 2020 and had adequate follow-up were included in the study. Medical record data were reviewed age, gender, etiology, features of family, treatment, and results.Three of the patients were female and 6 were male. Their average age was 11 years (4-17). All patients were evaluated as a drug-induced acute dystonic reaction. Of the 9 patients, 5 were due to metoclopramide, 3 were due to risperidone, and 1 was due to aripiprazole. It was learned that a similar situation against other drugs developed in the family history of 3 patients. As a treatment, all of them were intramuscularly applied biperiden suitable for their weight and 30 minutes dramatic improvement was observed. Additional dose had to be administered in only 1 case. All cases were discharged for 24 hours. No problem was observed in their follow-up.Drug-induced acute dystonic reaction can be diagnosed and has a clinical picture that completely resolves when effective treatment is applied. However, it should not be forgotten that it can reach life-threatening dimensions clinically.
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