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Clinical Review Fortnightly review

Acute dystonia induced by drug treatment

BMJ 1999; 319 doi: https://doi.org/10.1136/bmj.319.7210.623 (Published 04 September 1999) Cite this as: BMJ 1999;319:623

Rapid Response:

Acute Dystonia And Anaesthesia

In the interesting review article 'Acute dystonia induced by drug
treatment' Peter Harten and Colleagues [1] do not mention the anaesthetic
drugs as possible causes of acute dystonia.

There are several published reports where different anaesthetic
agents, for example; thiopentone , fentanyl and propofol administration
has been associated with opisthotonous and other abnormal neurologic
sequalae [2], [3], [4] .

In many of these reports it is difficult to establish a causal
relationship between the anaesthetic drug and the reported neurologic
sequalae, but it is equally hard to disprove it.

I think such unusual side effects of the anaesthetic agents should
deserve more attention to be paid particularly by Day Case Anaesthetists,
as many of these side effects can happen postoperatively when the patient
has been discharged from close medical care.

1 - Van Harten PN, Hoek HW, Kahn RS. Acute Dystonia induced by Drug
Treatment. BMJ 1999; 319: 623 – 626.

2 - Hooda S, Kiran S, Thapa D, Chhabra B. Opisthotonus and
thiopental. Anesth Analg 1995; 81(6): 1309-10.

3 - Dehring DJ, Gupta B, Peruzzi WT. Postoperative opisthotonus and
torticollis after fentanyl, enflurane, and nitrous oxide. Can J Anaesth.
1991; 38(7): 919-25. Review

4 - Saunders PR, Harris MN. Opisthotonus and other unusual
neurological sequelae after outpatient anaesthesia. Anaesthesia. 1990;
45(7): 552-7.

Competing interests: No competing interests

17 September 1999
Samer Abdalla
Anaesthetic SHO
The North Hampshire Hospital, Basingstoke, Hampshire, England