Samie M R, Dannenhoffer M A, Rozek S
Department of Neurology, State University of New York at Buffalo, Erie County Medical Center 14215.
Mov Disord. 1987;2(2):125-9. doi: 10.1002/mds.870020207.
A case of severe life-threatening tardive dyskinesia resulting in esophageal and respiratory difficulties due to metoclopramide therapy is presented. A 66-year-old man with a primary diagnosis of clear cell carcinoma of the biliary duct was treated with metoclopramide for gastrointestinal symptoms related to his chemotherapy regimen. The patient initially presented with tremor and rigidity in the upper extremities. On antiparkinsonian therapy, symptoms progressed to hemiballism and involuntary movements of the face, mouth, and tongue, with respiratory and esophageal dyskinesia. Despite discontinuance of metoclopramide, severe tardive dyskinetic symptoms resulted in placement of a gastrostomy tube to maintain nutritional support. This case along with others in the literature should emphasize the need for continuous reevaluation of metoclopramide during long-term therapy, since serious side effects have been reported to occur.
本文报告一例因甲氧氯普胺治疗导致严重的、危及生命的迟发性运动障碍，并引起食管和呼吸困难的病例。一名66岁男性，初步诊断为胆管透明细胞癌，因化疗方案相关的胃肠道症状接受甲氧氯普胺治疗。患者最初表现为上肢震颤和僵硬。在抗帕金森病治疗过程中，症状进展为偏身投掷症以及面部、口腔和舌头的不自主运动，并伴有呼吸和食管运动障碍。尽管停用了甲氧氯普胺，但严重的迟发性运动障碍症状导致放置胃造瘘管以维持营养支持。该病例以及文献中的其他病例应强调在长期治疗期间持续重新评估甲氧氯普胺的必要性，因为已有报道称会出现严重的副作用。
