Prolonged extrapyramidal syndrome due to metoclopramide overdose: a rare case report

Abstract Metoclopramide is a useful antiemetic drug that is widely used in medical emergencies. This drug can cause extrapyramidal side effects that are worrying. An 18-year-old girl student unintentionally consumed a large dose (60 mg) of metoclopramide, exceeding the recommended therapeutic dose, for the management of nausea and vomiting. Approximately six hours after the ingestion of the medication, she developed neck dystonia and upward deviation of the eyes. Seeing these symptoms and worrying about their child’s physical condition, the parents took her to the local medical center in northern Iran. With the diagnosis of the extrapyramidal syndrome and intramuscular administration of biperiden 5 mg ampoule twice at 12-h intervals, unfortunately, the symptoms did not improve and finally he was referred to our hospital. Dystonic reactions caused by metoclopramide can be misdiagnosed and it is necessary to be monitored and treated appropriately to reduce the family’s concern about its unpleasant side effects.