Abstract
A case of postoperative extrapyramidal symptoms is reported. A healthy 10-year-old boy was admitted to our hospital due to tonsillitis and adenoid hypertrophy pending tonsillectomy and adenoidectomy. A single dose of metoclopramide was given following an episode of vomit that occurred approximately 20 hours postoperatively. One hour subsequent to the administration of metoclopramide the patient developed fever, facial flushing, diaphoresis, headache, increased muscle rigidity, autonomic instability and altered level of consciousness. The clinical manifestations were present for approximately 22 hours. The patient received naloxone and symptomatic therapy and after 24 hours was fully recovered without complication. The ability of dopamine antagonist agents, including metoclopramide to precipitate extrapyramidal symptoms and drugs induced movement disorder is discussed [1]. These extrapyramidal and autonomic symptoms will be discussed as the early recognition of dystonia and/or akathisia by anesthetic personnel following the administration of metoclopramide is of great value for the punctual treatment of these conditions.
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