진토제의 사용으로 야기된 급성근긴장이상에 관한 치험례

A case report of acute dystonia caused by antiemetics (TRIMINⓇ)

Perphenzine(TriminⓇ), one of the phenothiazine derivatives, belongs to the neuroleptics. Because it has antiemetic effect in addition to antipsychotic effect, perphenazine has been used as the antiemetics. But it precipitate a surprising variety of motor disorders, presumably as a result of acute and chronic blockade of dopamine receptors in the basal ganglia and one of those is neuroleptic-induced acute dystonia. Acute dystonic reactions consist of sustained, often painful, muscular spasms producing twisting, squeezing, and pulling movements which occur within minutes or hours of neuroleptic exposure. The incience of this type of extrapyramidal side effect has been estimated to be 2~10%. This reactions occur more frequently in men than in women(2 : 1 ratio) and are also much more common in children and young adults than in the elderly. Common clinical presentations include opening or closing of the jaw, grimacing, tongue protrusions, torticollis, retrocollis, occulogyric crisis, opithotonic postition. This case report describe a neuroleptic(TriminⓇ)-induced acute dystonia happened to the sixteenyear-old male patient. We recommend that other surgeons should gain the information about the side effect of it before administration of the drug and keep attention to the choice of the neuroleptic agents as the antiemetics.