Procyclidine 5 mg IV worked a treat for a recent patient
Date:30/01/2004
-----Original Message-----
From: Accident and Emergency Academic List
[mailto:[log in to unmask]] On Behalf Of Rowley Cottingham
Sent: 14 August 2004 14:12
To: [log in to unmask]
Subject: Dystonias
23 year old comes in wiith uncontrollable movements. Hasn't taken his
neuroleptic drugs for 2 months. Ex heroin abuser,
controlled on methadone. Hep C and HIV positive; on no treatment. Admits to
smoking crack recently. No foreign
travel, no GI symptoms.
On examination is apyrexial. No rash. Mildly tachycardic, pupils not
dilated. Grimacing with lip-smacking and
head-turning. Conscious and able to speak. Crossing and uncrossing legs,
flailing arms from shoulders. The peripheries
seem less severely affected than centrally. Signs settle for a few hours
with diazepam 5mg but then return. Thoughts?
Rowley Cottingham.
Consultant in Emergency Medicine.
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