Dystonic Reaction to a Phenothiazine Presenting as Bellʹs Palsy, ,

An 11-year-old boy presented to the pediatric ED with signs and symptoms of Bellʹs palsy, which was believed to be a result of otitis media. He subsequently began to list to the left and could not walk erect. Because of a history of prochlorperazine use for vomiting, a diagnosis of a dystonic reaction to a phenothiazine was made, and the patient was treated with intravenous diphenhydramine. All symptoms resolved, including seventh nerve palsy, within 5 minutes of treatment. Medications are often prescribed by physicians for vomiting without caretakers being aware of the side-effects. Dystonic reactions can be severe and present with myriad neurologic signs and symptoms. [Bhopale S, Seidel JS: Dystonic reaction to a phenothiazine presenting as Bellʹs palsy. Ann Emerg Med August 1997;30:234-236.]