scholarly journals A case of delayed-onset multiple oculogyric crisis and torticollis episodes after low dose intramuscular haloperidol in a non-neuroleptic drug overdose setting

2021 ◽  
pp. 201010582110408 ◽  
Author(s):  
Howard Cai Hao Khoe ◽  
Vivian Shi Yin Wong
Keyword(s):  
Drug Overdose ◽  
Low Dose ◽  
Neuroleptic Drug ◽  
Anticholinergic Agent ◽  
Typical Antipsychotic ◽  
High Potency ◽  
Delayed Onset ◽  
Acute Dystonia ◽  
Oculogyric Crisis ◽  
Ocular Deviation

This report documents a rare case of delayed-onset multiple acute dystonias after treatment with low dose intramuscular (IM) haloperidol lactate injection in a setting of non-neuroleptic drug overdose. The drug–drug interactions between haloperidol and high levels of paracetamol and naproxen are deliberated upon. A 25-year-old Asian female was admitted after an intentional overdose of medications (paracetamol, naproxen and pregabalin). She received 5 mg of IM haloperidol injection for agitation. 21 hours later she experienced mild intermittent ocular deviation in an upward and outward direction and generalised stiffness, which were self-resolving. An hour later, she required another 2.5 mg of IM haloperidol injection for further agitation. In the 35 hours following her first IM haloperidol (13 hours after the second IM haloperidol), she developed a total of three episodes of oculogyric crisis (OGC) with torticollis. Each episode was treated promptly with IM diphenhydramine 25 mg, and there was remission of symptoms within 15 minutes of treatment. An objective causality assessment revealed a definite relationship between the episodes of acute dystonia with IM haloperidol therapy. Where oral alternatives and IM atypical antipsychotics/benzodiazepines are unavailable, rapid tranquillisation with a high-potency typical antipsychotic is a possibility. However, consideration should be made to combine haloperidol with an anticholinergic agent as prophylaxis against acute dystonia, especially in the setting of drug overdose, even if it is that of a non-neuroleptic drug (in this case, paracetamol and naproxen).

Oculogyric Crisis Due to Low-Dose Olanzapine

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Semih Erden ◽  
Hurşit Ferahkaya
Keyword(s):  
Low Dose ◽  
Oculogyric Crisis

Plasma leptin concentration and its interrelation with some blood metabolites, metabolic hormones and the resumption of cyclic ovarian function in postpartum dairy cows supplemented with monensin or inert fat in feed

2001 ◽  
Vol 26 (2) ◽  
pp. 405-409 ◽  
Author(s):  
Gy. Huszenicza ◽  
M. Kulcsar ◽  
J. A. Nikolic ◽  
J. Schmidt ◽  
P. Korodi ◽  
...  
Keyword(s):  
Dairy Cows ◽  
Low Dose ◽  
Ovarian Function ◽  
Metabolic Hormones ◽  
Delayed Onset ◽  
Wide Range ◽  
Significant Difference ◽  
Minimal Concentration ◽  
Plasma Leptin ◽  
Ovarian Cyclicity

AbstractThe postpartum changes in plasma leptin levels of dairy cows ovulated within 35 days after calving were compared to of those with delayed onset of cyclicity in two experiments. The cows were sampled for leptin, insulin, IGF-1, thyroid hormones (T4, T3, rT3), Cortisol and also for some metabolites (glucose, NEFA, BHB and TCH) on day 1-3 after calving and again four times 7 days apart (Exp. 1), or in weeks 1, 2, 3, 5 and 10 postpartum (Exp. 2). In Exp. 1 also the standard low dose ACTH-induced Cortisol response and TRH-stimulated T4/T3 responses were determined on days 1-3 and 28-35. In cows of Exp. 1 the leptin level varied within a wide range with a mean of about 4 ng/ml HE in the first samples. Up to week 5 it remained unchanged in cows ovulated within day 35 but reduced in those with delayed onset of cyclicity, resulting in significant difference between the two group means.In cows of Exp. 2 the week 1 leptin levels were lower and less variable than that of Exp. 1. In weeks 2 and 3 a slightly increasing tendency of leptin pattern was seen in cows resuming their ovarian cyclicity within 35 days whereas in those with delayed onset of cyclicity the leptin level remained unchanged. Up to week 5 this tendency resulted in exactly the same leptin values as seen in Exp. 1 with significant differences between the group means in both of the weeks 5 and 10. It was concluded that the plasma leptin concentration in postpartum dairy cows may interfere with resumption of cyclic ovarian function, but its influence may be only permissive (e.g. a minimal concentration above a supposed threshold seems to be the prerequisite of the onset of cyclicity)

Oculogyric crisis: A syndrome of thought disorder and ocular deviation

1987 ◽  
Vol 22 (1) ◽  
pp. 13-17 ◽  
Author(s):  
R. John Leigh ◽  
Joseph M. Foley ◽  
Bernd F. Remler ◽  
Richard H. Civil
Keyword(s):  
Thought Disorder ◽  
Oculogyric Crisis ◽  
Ocular Deviation

scholarly journals Delayed-Onset Seizure in a Mild Quetiapine Overdose: Report of a Case and Review of the Literature

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Jason A. Chen ◽  
Katherine M. Unverferth ◽  
Erick H. Cheung
Keyword(s):  
Atypical Antipsychotics ◽  
Low Dose ◽  
Clonic Seizure ◽  
Tonic Clonic Seizure ◽  
Review Of The Literature ◽  
Potential Complication ◽  
Onset Seizure ◽  
Pharmacokinetics And Pharmacodynamics ◽  
Delayed Onset ◽  
Unusual Phenomenon

Among atypical antipsychotics, quetiapine is commonly prescribed and considered to have a favorable side effect and safety profile. Here, we report the case of a patient who developed a generalized tonic-clonic seizure 28 hours following ingestion of 1,400 mg of quetiapine. Review of the literature identifies delayed-onset seizure as a potential complication of quetiapine overdose. Unique to this case, delayed-onset seizures occurred in a patient with a relatively low dose of quetiapine and no obvious toxidrome, suggesting that this reaction may be an important consideration in the management of quetiapine overdose. The pharmacokinetics and pharmacodynamics of quetiapine may explain this unusual phenomenon.

scholarly journals Aripiprazole-induced oculogyric crisis (acute dystonia) in 11 years old girl: a case report

2020 ◽  
Author(s):  
Cansu MERCAN IŞIK ◽  
Belde DEMİRCİ ◽  
Seda Aybüke SARI ◽  
Ayla UZUN ÇİÇEK
Keyword(s):  
Case Report ◽  
Acute Dystonia ◽  
Oculogyric Crisis

Delayed Onset of Oculogyric Crisis and Torticollis with Intramuscular Haloperidol

2003 ◽  
Vol 37 (10) ◽  
pp. 1434-1437 ◽  
Author(s):  
Stanford S Jhee ◽  
Victoria Zarotsky ◽  
Stephen M Mohaupt ◽  
Cynthia L Yones ◽  
Steve J Sims
Keyword(s):  
Delayed Onset ◽  
Oculogyric Crisis

scholarly journals Oculogyric Crisis in a patient with PURA Syndrome

2021 ◽  
Author(s):  
Icaro França Navarro Pinto ◽  
Wladimir Bocca Vieira de Rezende Pinto ◽  
Igor Braga Farias ◽  
Bruno de Mattos Lombardi Badia ◽  
Gustavo Carvalho Costa ◽  
...  
Keyword(s):  
Eye Movements ◽  
Neurodevelopmental Disorder ◽  
Tube Feeding ◽  
Final Diagnosis ◽  
Epileptic Encephalopathy ◽  
Psychomotor Development ◽  
Feeding Difficulties ◽  
Whole Exome ◽  
Oculogyric Crisis ◽  
Ocular Deviation

Context: PURA syndrome is a neurodevelopmental disorder characterized by neonatal hypotonia, delayed psychomotor development, early-onset feeding difficulties and an epileptic encephalopathy. Case Report: A 3-month-old Brazilian boy presented with severe neonatal hypotonia associated with feeding difficulties due to serious dysphagia requiring nasoenteral tube feeding. Excessive drowsiness, poor social interaction and repetitive episodes of involuntary abnormal upward eye movements and ocular version with short duration were also reported by parents. Neurological examination revealed severe axial and upper limb hypotonia, orofacial dyskinetic movements and episodes of abnormal eye movements with upward ocular deviation with less than 30 seconds in duration compatible with oculogyric crisis. It was performed Whole-Exome sequencing and it was identified a new pathogenic variant in PURA gene that establisehd the final diagnosis of PURA Syndrome or Autosomal Dominant Mental Retardation type 31, MDR 31 (OMIM #616158). Conclusions: PURA Syndrome emerges as one of the major differential diagnoses of neonatal hypotonia and in addition, we can consider the early manifestation of oculogyric crisis as a phenotypic expansion of the syndrome, making its diagnosis even more challenging, since epileptic encephalopathies and neurotransmitter deficiency-related diseases present with a similar clinical course.

Delusional Parasitosis in the Elderly: A Review and Report of Six Cases From Northern Finland

1997 ◽  
Vol 9 (4) ◽  
pp. 459-464 ◽  
Author(s):  
Pirkko Räsänen ◽  
Kari Erkonen ◽  
Ulrica Isaksson ◽  
Pirjo Koho ◽  
Risto Varis ◽  
...  
Keyword(s):  
Older Women ◽  
Elderly Woman ◽  
Low Dose ◽  
The Elderly ◽  
Test Results ◽  
High Potency ◽  
Cutaneous Lesions ◽  
Delusional Parasitosis ◽  
Socially Isolated ◽  
Insight Into

A patient with delusional parasitosis has a strong conviction of being infested with parasites: for example, lice or worms. Such a patient is not satisfied with assurances or test results that no parasites are present, but is so convinced that he or she will go as far as to bring the parasites in “matchboxes” to a physician. Subjectively worried, the patient may try to pick the parasites out of the skin, causing cutaneous lesions and even ulcerations. The condition is classified as a delusional/paranoid disorder, somatic type according to DSM-III-R. Not much is known epidemiologically of this rare disorder, which usually affects older women who often are isolated socially. Therapy is regarded as difficult, and a wide variety of treatment methods have been attempted. In this article six female cases are presented, showing that a typical patient is an elderly woman who has suffered losses or is socially isolated. These patients lack deeper psychiatric insight into their problem, so they are mostly in the care of nonpsychiatric physicians. Treatment with a low dose of high-potency neuroleptics combined sometimes with antidepressants appears to be effective. Reducing social isolation is also important.

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