Perioperative Dystonia Mimicking Convulsion: Awareness Is the Key to Diagnosis

Dystonia, a variant of acute extrapyramidal symptoms (EPS), is a known side effect of neuroleptics. It is a rare but well-recognized complication in perioperative settings. Most of the reported cases have been linked to the perioperative use of metoclopramide. Dystonic reactions typically present as repetitive movements or abnormal posturing of the head, neck, and body. These reactions usually last only for a few minutes and are rarely lethal. However, occasionally they may present as sustained laryngopharyngeal muscle spasms, potentially leading to fatal airway obstruction. In this report, we present the case of an elderly female patient who developed a life-threatening episode of dystonia mimicking convulsion in the postoperative period. She had received metoclopramide as pre-anesthetic medication before surgery.