Article ID: 11046
A 76-year-old woman was transferred to our hospital with sudden-onset of impaired consciousness, conjugate eye deviation to the right, and left hemiplegia. MRI showed intraarterial sign, suggestive of occlusion in the right middle cerebral artery. 40 minutes after her visit, she showed dramatic improvement of symptoms by spontaneous recanalization. After improvement of symptoms, she vomited, and 10 mg of metoclopramide was intravenously injected in a bolus. After 1 hour of injection, dyskinesia was present on her oral tongue and limbs. Clinical diagnosis of metoclopramide-induced acute dyskinesia was made. Dyskinesia was improved over time by biperiden. Metoclopramide is a typical antiemetic drug frequently used in daily practice, and it can cause tardive dyskinesia when administered for a long period. Rarely, acute extrapyramidal disorders including dyskinesia may occur by intravenous injection even in a single and a normal dose of metoclopramide. Vomiting is a common symptom in stroke care. When administering metoclopramide, the past history and the family history of similar symptoms should be confirmed, and slow drip infusion is desirable to prevent acute extrapyramidal disorders.
