Neurology: drug-induced acute dystonia: practice question

A General Medicine question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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General Medicine · Neurology: drug-induced acute dystonia

Sample item

A 22-year-old man given intravenous metoclopramide for vomiting develops painful sustained neck twisting, tongue protrusion and upward eye deviation within hours. What is the best treatment?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Parenteral anticholinergic such as benztropine

Dopamine receptor blockers can cause acute dystonia within days, particularly in young men. A parenteral anticholinergic or antihistamine such as benztropine or diphenhydramine relieves it rapidly, and the offending drug is stopped.

Option by option

  • A. Dantrolene by rapid intravenous infusion

    Dantrolene treats malignant hyperthermia and is not used here.

  • B. Parenteral anticholinergic such as benztropine (correct)

    Correct. Anticholinergics restore the dopamine-acetylcholine balance and relieve dystonia.

  • C. Intramuscular haloperidol to settle agitation

    Haloperidol is another dopamine blocker and would worsen it.

  • D. Oral levodopa-carbidopa

    Levodopa is not used for acute drug-induced dystonia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this General Medicine question

What is the answer to this General Medicine question?

The best answer is B, Parenteral anticholinergic such as benztropine. Dopamine receptor blockers can cause acute dystonia within days, particularly in young men.

Why is "Dantrolene by rapid intravenous infusion" not the answer?

Dantrolene treats malignant hyperthermia and is not used here.

Why is "Intramuscular haloperidol to settle agitation" not the answer?

Haloperidol is another dopamine blocker and would worsen it.

Why is "Oral levodopa-carbidopa" not the answer?

Levodopa is not used for acute drug-induced dystonia.

What concept does this question test?

It tests Neurology: drug-induced acute dystonia in General Medicine. A parenteral anticholinergic or antihistamine such as benztropine or diphenhydramine relieves it rapidly, and the offending drug is stopped.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neurology: drug-induced acute dystonia?

For each disease know the classic presentation, the best test, and the first-line treatment. Then use the flashcards and the other General Medicine questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.