Dystonic Reaction of Pharyngeal+Laryngeal Muscles

Etiology

  • Neuroleptics (usually occurs after a few days of therapy): Haldol/ Phenothiazines/ Thioxanthenes
    • Risk factors for neuroleptic-induced dystonia:
      • Young male sex
      • Use of high potency neuroleptic agents

Physiology

  • Dystonic reaction of upper airway muscles -> upper airway obstruction

Clinical

  • Torticollis
  • Retrocollis
  • Oculogyric crisis
  • Tongue and jaw stiffness
  • Opisthotonus
  • Although rare, dystonia may involve only upper airway muscles in some cases

Treatment

  • IV Benadryl (centrally acting anticholinergic): effective

References

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