[Acute-onset extrapyramidal syndromes caused by drugs]

Area of Science:

• Pediatric Neurology
• Clinical Toxicology

Context:

• Acute poisoning in children presents a significant clinical challenge.
• Extrapyramidal syndromes are serious adverse drug reactions requiring prompt recognition and management.

Purpose:

• To investigate the incidence and causative agents of acute extrapyramidal syndromes in pediatric poisoning cases.
• To evaluate the efficacy of diphenhydramine in managing these drug-induced movement disorders.

Summary:

• Out of 321 children with acute poisoning, 49 (14.9%) developed acute extrapyramidal syndromes.
• Phenothiazines and haloperidol were the primary drug culprits, with metoclopramide implicated in two cases.
• Syndromes included akathisia, dyskinesia, dystonic reactions, parkinsonism, and akinesia.
• Intravenous and oral diphenhydramine demonstrated utility in treating these acute extrapyramidal disturbances.

Impact:

• Highlights the prevalence of drug-induced extrapyramidal syndromes in pediatric poisoning.
• Provides evidence for diphenhydramine as a treatment option for these emergencies.
• Informs clinical practice regarding the recognition and management of adverse drug reactions in children.