ABSTRACT 745

Abstract

Background and aims: Dystonia is a neurologic movement disorder, in which causes involuntary muscle contractions and abnormal postures. We reported a case of generalized form of dystonia after taking albendazole and cetirizine. Only one case with albendazole and two cases with cetirizine induced dystonia were previously reported. Methods: Case: A three years and six months old boy who rapidly developed lateral flexion of neck, extension of forearms, adduction and flexion of arms was presented to Pediatric Emergency Department. According to the history, he received only single dose of albendazole and cetirizine 20 hours ago, because of a probable worm infection. Except dystonia, examination was normal. He was managed as dystonia based on history and signs. His symptoms resolved after six hours of intramuscular biperiden treatment. On follow-up visit at the 24th hour of onset, the patient had no complaint. He was thought to be drug-induced dystonia caused by albendazole and/or cetirizine. Conclusions: Antiemetics, antidepressants, dopamine-blocking agents and antipsychotics are the best-known cause of drug induced dystonia. Cetirizine is a high selective histamine H1 receptor antagonist which has dopamine receptor blocking properties in susceptible individuals and may cause dystonic movements. Albendazole affects the cell by inhibiting tubulin polymerization. Two drugs separately or both may be responsible from dystonia in our patient. The metabolic effects of cetirizine are longer acting than effect of albendazole. The patient developed dystonia in nearly 20 hours after taking these two drugs. Therefore, we speculated that in this case cetirizine may lead to dystonia because of its long acting.