Isolated Lingual Dystonia as the Manifestation of Acute Extrapyramidal Syndrome Induced by Metoclopramide

Abstract

Oromandibular dystonia is characterized by persistent contractions and repetitive spasms of masticatory muscles surrounding the oral cavity and lingual muscles. The lingual dystonia is rare hyperkinetic movement disorder, often occurring secondary to drugs. The common drugs which can cause acute focal dystonia are neuroleptics, antiemetics, and antipsychotics. Isolated lingual dystonia is a rare form of disabling focal dystonias. We report a young female, who developed tongue dystonia in isolation and responding favorably to antihistaminics. The physicians are advised to make inquiry about administered drugs in isolated lingual dystonia.

Keywords: Abnormal postures; antiemetics; focal dystonia; metoclopramide; muscle contractions; oromandibular dystonia.

Figure 1

Patient photograph demonstrating vertical sustained posture of the tongue (lingual dystonia)

Figure 2

Normal tongue movement after treatment