Acute cervical dystonia induced by one dose of butamirate citrate: A case report and review of literature from Hamad General Hospital Emergency, a tertiary hospital in Qatar

Abstract

Dystonia is defined as abnormal muscle contraction or twisting or repetitive movements that result in sustained and abnormal posture. Cervical dystonia (CD) is one form of dystonia that involves neck muscles and leads to involuntary movements of the neck and head. Many centrally acting medications such as antipsychotics and antidepressants were reported to cause acute dystonia, as they cause an extrapyramidal side effect. We present the case of a female adult patient who had acute CD after 2 hours of the first dose of butamirate citrate, a centrally acting cough syrup, which rarely causes central nervous side effects. The patient developed neck pain, spasm, and rigidity, which worsened over time. She improved after the first dose of benztropine, an anticholinergic medication which is one of the treatment options for treating CD. This case has shown that even in OTC medications with a good safety profile, critical side effects happen, which indicates that clinicians need to be more attentive to patient’s medication history prior to critical events such as acute CD.