Cetirizine-induced dystonic movements

Abstract

Drug-induced movement disorders are most commonly associated with neuroleptics. There are a few reports of abnormal involuntary movements associated with antihistamines. We present a case of involuntary dystonic movements triggered independently by cetirizine and mepyramine maleate in a child. A 4-year-old girl (19.5 kg) presented with unusual head and upper limb movements following 18-day use of cetirizine (5 mg/day) for presumptive allergic rhinitis. Symptoms began with a right eye tic followed by frequent shoulder shrugging the next day. The cetirizine was discontinued when she developed intermittent retrocollis on day 20. Retrocollis worsened the following day, and she developed bilateral shoulder shrug and arm abduction movements. These movements did not interfere with voluntary movements. There was no oculogyric crisis and no sustained dystonic posturing. The movements were painless, aggravated by fatigue, and briefly suppressible. General examination by the pediatrician revealed a developmentally appropriate child. Her nasal turbinates were enlarged and …