Oculogyric crisis

Jump to navigation Jump to search

WikiDoc Resources for Oculogyric crisis


Most recent articles on Oculogyric crisis

Most cited articles on Oculogyric crisis

Review articles on Oculogyric crisis

Articles on Oculogyric crisis in N Eng J Med, Lancet, BMJ


Powerpoint slides on Oculogyric crisis

Images of Oculogyric crisis

Photos of Oculogyric crisis

Podcasts & MP3s on Oculogyric crisis

Videos on Oculogyric crisis

Evidence Based Medicine

Cochrane Collaboration on Oculogyric crisis

Bandolier on Oculogyric crisis

TRIP on Oculogyric crisis

Clinical Trials

Ongoing Trials on Oculogyric crisis at Clinical Trials.gov

Trial results on Oculogyric crisis

Clinical Trials on Oculogyric crisis at Google

Guidelines / Policies / Govt

US National Guidelines Clearinghouse on Oculogyric crisis

NICE Guidance on Oculogyric crisis


FDA on Oculogyric crisis

CDC on Oculogyric crisis


Books on Oculogyric crisis


Oculogyric crisis in the news

Be alerted to news on Oculogyric crisis

News trends on Oculogyric crisis


Blogs on Oculogyric crisis


Definitions of Oculogyric crisis

Patient Resources / Community

Patient resources on Oculogyric crisis

Discussion groups on Oculogyric crisis

Patient Handouts on Oculogyric crisis

Directions to Hospitals Treating Oculogyric crisis

Risk calculators and risk factors for Oculogyric crisis

Healthcare Provider Resources

Symptoms of Oculogyric crisis

Causes & Risk Factors for Oculogyric crisis

Diagnostic studies for Oculogyric crisis

Treatment of Oculogyric crisis

Continuing Medical Education (CME)

CME Programs on Oculogyric crisis


Oculogyric crisis en Espanol

Oculogyric crisis en Francais


Oculogyric crisis in the Marketplace

Patents on Oculogyric crisis

Experimental / Informatics

List of terms related to Oculogyric crisis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Luke Rusowicz-Orazem, B.S.


Oculogyric crisis (OGC) is the name of a dystonic reaction to certain drugs and/or medical conditions. The term "Oculogyric" refers to rotating of eyeballs,[1] but several other responses are associated with the crisis.


Drugs that can trigger an oculogyric crisis include neuroleptics, amantadine, benzodiazepines, carbamazepine, chloroquine, cisplatin, diazoxide, influenza vaccine, levodopa, lithium, metoclopramide, nifedipine, pemoline, phencyclidine, Perphenazine, reserpine, and tricyclics.

Other causes can include postencephalitic Parkinson's, Tourette's syndrome, multiple sclerosis, neurosyphilis, head trauma, bilateral thalamic infarction, lesions of the fourth ventricle, cystic glioma of the third ventricle, herpes encephalitis, and juvenile Parkinson's.

Symptoms and signs

Initial symptoms include incredible restlessness, agitation, malaise, or a fixed stare. Then comes the more characteristically described extreme and sustained upward deviation of the eyes. In addition, the eyes may converge, deviate upward and laterally, or deviate downward. The most frequently reported associated findings are backwards and lateral flexion of the neck, widely opened mouth, tongue protrusion, and ocular pain. However it may also be associated with intensely painful jaw spasm which may result in the breaking of a tooth. A wave of exhaustion may follow an episode. The abrupt termination of the psychiatric symptoms at the conclusion of the crisis is most striking.

Other features that are noted during attacks include mutism, palilalia, eye blinking, lacrimation, pupil dilation, drooling, respiratory dyskinesia, increased blood pressure and heart rate, facial flushing, headache, vertigo, anxiety, agitation, compulsive thinking, paranoia, depression, recurrent fixed ideas, depersonalization, violence, and obscene language.

It is often not realized that in addition to the acute presentation, OGC can develop as a recurrent syndrome, triggered by stress, and exposure to the above drugs.


Life Threatening Causes

Common Causes

Causes by Organ System

Cardiovascular Cystic glioma of the third ventricle, Lesions of the fourth ventricle
Chemical / poisoning No underlying causes
Dermatologic No underlying causes
Drug Side Effect Oxcarbazepine, Promethazine, Carbamazepine, Cetirizine, Chloroquine, Chlorpromazine, Cisplatin, Diazoxide, Domperidone, Fluphenazine, Haloperidol, Levodopa, Lithium, Metoclopramide, Neuroleptics, Nifedipine, Olanzapine, Pemoline, Phencyclidine, Reserpine, Sepiapterin reductase deficiency
Ear Nose Throat No underlying causes
Endocrine No underlying causes
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic No underlying causes
Hematologic Tubb4a-related leukodystrophy
Iatrogenic No underlying causes
Infectious Disease Herpes encephalitis, Influenza vaccine, Neurosyphilis, Tertiary syphilis
Musculoskeletal / Ortho No underlying causes
Neurologic Bilateral thalamic infarction, Bilateral thalamic lesion, Gilles de la tourette syndrome, Herpes encephalitis, Juvenile parkinson's, Kernicterus , Multiple sclerosis, Neuroleptics, Neurosyphilis, Parkinson disease, Postencephalitic parkinson's, Tourette's syndrome
Nutritional / Metabolic No underlying causes
Oncologic Cystic glioma of the third ventricle
Opthalmologic No underlying causes
Overdose / Toxicity No underlying causes
Psychiatric No underlying causes
Pulmonary No underlying causes
Renal/Electrolyte No underlying causes
Rheumatology/Immunology/Allergy No underlying causes
Sexual Tertiary syphilis
Trauma Head trauma
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order


Immediate treatment of drug induced OGC can be achieved with intravenous antimuscarinic benztropine or procyclidine; which usually are effective within 5 minutes, although may take as long as 30 minutes for full effect. Further doses of procyclidine may be needed after 20 minutes. Any causative new medication should be discontinued.



Template:Skin and subcutaneous tissue symptoms and signs Template:Nervous and musculoskeletal system symptoms and signs Template:Urinary system symptoms and signs Template:Cognition, perception, emotional state and behaviour symptoms and signs Template:Speech and voice symptoms and signs Template:General symptoms and signs

Template:WikiDoc Sources