Myoclonus induced by metoclopramide therapy

Area of Science:

• Neurology
• Pharmacology

Background:

• Metoclopramide hydrochloride is a widely used antiemetic agent known for its dopamine antagonism.
• Previous studies have documented extrapyramidal side effects associated with its use in gastrointestinal disorders.

Observation:

• A patient developed multifocal myoclonic jerking after receiving metoclopramide for gastroparesis secondary to renal failure.
• The patient had no prior neurological symptoms, and no central nervous system abnormalities were detected.

Findings:

• Metoclopramide therapy precipitated multifocal myoclonic jerking in a patient with renal failure.
• Neurologic symptoms resolved upon discontinuation of metoclopramide, indicating a drug-induced effect.

Implications:

• Metoclopramide-induced myoclonus is a potential complication in patients with impaired renal function.
• Differentiating drug-induced myoclonus from seizures is crucial in patients with metabolic encephalopathies like renal failure.
• Reduced metoclopramide clearance in renal failure may increase the risk of neurologic complications with standard dosing.