شاب عمره ٢٢ سنة أخذ ميتوكلوبراميد للقيء. بعد ساعات صارت رقبته ملتوية وعيونه تنظر للأعلى بدون تحكم، وهو خائف جداً. العلامات الحيوية طبيعية. ما التفسير الأرجح؟

A 22-year-old took metoclopramide for vomiting. Hours later his neck twists and his eyes roll upward uncontrollably; he is very frightened. Vitals are normal. What is the most likely explanation?

1. An acute dystonic reaction to metoclopramide
2. A panic attack from illness anxiety
3. A brainstem stroke
4. A new seizure disorder needing an urgent EEG

Answer: A) An acute dystonic reaction to metoclopramide. Metoclopramide blocks dopamine and can cause acute dystonia (torticollis, oculogyric crisis), more often in the young. Stop it and treat with diphenhydramine or benztropine.