Haloperidol-Induced Laryngeal Dystonia: A Case Report on an Antipsychotic-Associated Airway Emergency

Abstract

Acute dystonia is a neurological condition characterized by involuntary muscle contractions that can affect various parts of the body. It is commonly triggered by the use of antipsychotic medications, especially within the first few days after administration. Respiratory acute laryngeal dystonia, a particularly severe form of this condition and a very subtype of laryngeal dystonia, can lead to respiratory distress and airway obstruction if not promptly treated. This case report describes a 23-year-old male who developed acute laryngeal dystonia within 24 hours of receiving haloperidol for agitation. The patient presented with hoarseness, difficulty swallowing, and progressive respiratory distress, eventually requiring emergent intubation due to airway compromise. This case underscores the need for healthcare providers to recognize and promptly manage rare but potentially life-threatening side effects of antipsychotic medications. Particular attention must be directed toward patients with risk factors for developing extrapyramidal reactions. Early intervention is crucial to prevent progression to airway obstruction and respiratory failure.

Keywords: antipsychotic medication; critical airway; emergency; haloperidol-induced; laryngeal dystonia.

Figure 1. Frontal view of the chest demonstrates a normal cardio-mediastinal silhouette without focal consolidation, pleural effusion, or pneumothorax.

There is a stable right hemidiaphragm elevation (red arrow). Endotracheal tube terminates at the superior margin of the clavicular heads, 4.6 cm above the carina (blue arrow).