PART 2: An interesting case

Doctor Speaks

A 14-year-old lymphoma patient presented to the ER with acute dystonia just 48 hours after chemotherapy—triggering a broad differential diagnosis including CNS involvement, metabolic imbalance, and drug toxicity. After careful evaluation, the culprit was identified as metoclopramide-induced extrapyramidal symptoms (EPS), a rare but important clinical mimic in oncology patients. This case highlights the importance of medication review and vigilance for adverse drug reactions in cancer care. Early recognition can prevent unnecessary investigations and provide rapid symptom relief with appropriate treatment. #Lymphoma #Oncology #ExtrapyramidalSymptoms #AcuteDystonia #Metoclopramide #ChemotherapyComplications #CancerCare #MedicalEducation #DoctorLife #ClinicalCase #RarePresentation #ERMedicine #PatientSafety #AdverseDrugReaction #MedEd

Transcript

00:00Then I sat down and started taking history.

00:04Obviously, we take history before, but I started digging deep down.

00:10So, I clicked on drug history that maybe there is a drug which is causing this trouble.

00:18So, he was taking paracetamol and metoclopramide.

00:26Which is commonly used for vomiting nausea.

00:30Which is commonly used in cancer patients.

00:38So, the research begins on that.

00:41You can open the books and read it.

00:44So, it clicked on that it can be, which is very rare obviously,

00:49but it can be metoclopramide induced, extra-perimidal signs and symptoms.

00:56Acute dystonia and these are extra-perimidal signs and symptoms.

01:01So, it can be due to this.

01:03So, that decision was made.

01:05The drug was closed, obviously.

01:07But after that, an anticholinergic agent gave it to me.

01:11And within 20-95 minutes, he responded.

01:15And he said,

01:16Alhamdulillah, it's totally fine.

01:18So, sometimes,

01:20those things that we use very commonly,

01:23they also have side effects.

01:27But the important thing is that

01:29you need to be in your brain

01:30that there are some side effects from this disease.

01:35So, in oncology patients,

01:37if you have intracranial signs symptoms,

01:41neurological signs symptoms,

01:44then not always should you suspect

01:46that the disease has increased.

01:49But there can be

01:51itrogenic causes also.

01:53So, this was the case.

01:55And I thought it is worth sharing.

01:57So, this is all.

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