Dystonic-like reaction following cisapride therapy

A 43-year-old woman with gastroesophageal reflux disease developed a dystonic-like reaction approximately 3 days after starting oral cisapride therapy. Office evaluation revealed a patient who moved her head rhythmically from side to side as she stared into space, generally unresponsive to external stimuli. She had increased tone of the sternocleidomastoid muscles bilaterally, with occasional tongue protrusion, and a slow shuffling gait. Following discontinuation of cisapride, the patient recovered completely.