Recurrent Temporomandibular Joint Dislocation Due to Antiemetic Induced Acute Dystonia: A Case Report

Abstract

Introduction: Drug-induced acute dystonic reaction is a common presentation to emergency department. Oromandibular dystonia is one of the focal dystonias, which can be presented as jaw clenching, jaw opening or jaw deviation and leads to impaired speech and swallowing. In this paper, we presented an adult patient with recurrent temporomandibular joint dislocation due to metoclopramide use.
 Case Report: A 21-year-old female patient came to the emergency department with the complaints of inability chew and swallow, difficulty in speaking, pain at right temporomandibular region that started a few hours ago. On physical examination, she was having dystonia of the right mandibular region and left posterior servikal region and no dystonia at other parts of the body. The patient was diagnosed with metoclopramide-induced acute dystonia. She was treated with intravenous anticholinergic.
 Conclusion: Metoclopramide is an antiemetic drug that can cause serious adverse events such as acute dystonic reaction. Among these side effects are oromandibular dystonias, which may lead to TMJ dislocation. Physicians and other healthcare professionals working in the emergency department should be familiar with such side effects.