Zusammenfassung
Wir berichten über den Fall einer Sulpirid-induzierten Dystonie bei einem
Patienten mit einem bekannten Tourette Syndrom. Aufgrund des plötzlichen
Auftretens einer schlaganfallähnlichen Symptomatik während einer
körperlichen Belastung war die eigentliche Dystoniediagnose erschwert.
Nach Ausschluss einer vaskulären Ursache (Blutung,
Gefäßdissektion, etc.) durch geeigneter Bildgebung wurde
Biperiden infundiert, welche zum sofortigen Verschwinden der Dystonie
führte.
Abstract
We present a case of a 23-year-old male Caucasian patient admitted to the
emergency department because of an acute onset of difficulty of articulation,
weakness of the left arm, throat- and neck pain. An emergency CT & MRI
of the brain showed no abnormalities. The Patient had started visiting a new
neurologist three weeks before admission and received Sulpiride against Tourette
syndrome (TS) in a rapid escalation manner over a short period. Sulpiride
induced dystonia and other neurological symptoms that were clinically masked by
dystonic and clonic tics of the known TS. 5 mg Biperiden (anticholinergic agent)
was slowly injected intravenously under monitor condition. The Patient reported
an immediate disappearance of articulation difficulties, left arm movement, and
cervical and neck pain. After discontinuing Sulpiride the patient did not
develop such attacks anymore and could be discharged the next day. This case
shows the development of dystonia in correlation to the use of Sulpiride, which
involved the cervical region, the laryngeal muscles, and the left upper
extremity. Our case is of particular interest to neurologists and psychiatrists,
because of their involvement in the treatment of TS. Therefore, young
neurologists must be aware of such complications when thinking of differential
diagnosis in movement disorders particularly in TS.
Schlüsselwörter
Sulpirid - Dystonie - Tourette Syndrom - unerwünschte Effekte
Key words
Sulpirid - Tourette Syndrom - Dystonie
