Rowley Cottingham <[log in to unmask]>typed
> 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?
<random thoughts>
I've seen dystonia from Distalgesic (Co-proxamol) given to young chap,
for backache IIRC, by his mum. I reported that to CSM as I'd not seen it
before.
I've also seen, for example dystonia in a lad who thought he'd get high
on his brother's sulpiride, which was not surprising.
Did patient take *any* medicine from *anyone*?
OTC meds are getting less restricted and I think some migraine
treatments may contain prochlorperazine.
--
Helen D. Vecht: [log in to unmask]
Edgware.
|