Akathisia preceding an oculogyric crisis in a patient treated with prochlorperazine for hyperemesis gravidarum

Abstract

AbstractProchlorperazine is a class I-A anti-emetic recommended for the treatment of severe nausea and vomiting in pregnancy. We present a case where a patient presented with hyperemesis gravidarum refractory to pyridoxine/doxylamine and dimenhydrinate and developed akathisia and dystonia after receiving prochlorperazine. Her condition resolved immediately following the administration of diphenhydramine. While procholorperazine is known to very rarely cause focal dystonias such as an oculogyric crisis, the influence of phenothiazines and neuroleptics on dopaminergic receptors can also trigger behavioural changes, which can rapidly evolve into a life-threatening condition.