Rotatory nystagmus after granisetron administration
Authors: Abdulelah Shafiq Abualfraj , Ammar Ismail , Azzah Aljabarti , Maan Jamjoom
Abstract
Background: Granisetron is a popular antiemetic medication used in the emergency department to control nausea and vomiting with an excellent side effect profile among adults and pediatric, in both healthy and oncology patients. Case Presentation: Our patient received granisetron for nausea and vomiting then developed torsional nystagmus, asymmetrical abnormal muscle contractions, and electrocardiography showed QTc prolongation 487 ms. The patient did improve after IV lorazepam and magnesium sulphate administration. Conclusion: QTc prolongation increases the risk of developing Torsades de Pointes and sudden death. Extrapyramidal syndrome caused by granisetron is rare and should not be confused with seizure. Both are significant effects associated with 5-HT3 antagonists administration to be aware of and if they occurred, should be managed in a timely fashion.Keywords: Antiemetics, granisetron, extrapyramidal syndrome, nystagmus, rotatory nystagmus, QTc prolongation, Torsades de Pointes, beetroot effect
Pubmed Style
Abdulelah Shafiq Abualfraj, Ammar Ismail, Azzah Aljabarti, Maan Jamjoom. Rotatory nystagmus after granisetron administration. SJE Med. 2021; 19 (January 2021): 96-101. doi:10.24911/SJEMed/72-1597503713
Publication History
Received: August 16, 2020
Accepted: November 29, 2020
Published: January 19, 2021
Authors
Abdulelah Shafiq Abualfraj
Emergency Medicine Department, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, Emergency Medicine Physician, King Abdulaziz Medical City, Jeddah, Saudi Arabia
Ammar Ismail
Emergency Medicine Department, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, Emergency Medicine Consultant, King Abdulaziz Medical City, Jeddah, Saudi Arabia
Azzah Aljabarti
Emergency Medicine Department, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, Emergency Medicine Consultant, King Abdulaziz Medical City, Jeddah, Saudi Arabia
Maan Jamjoom
Emergency Medicine Department, Ministry of the National Guard - Health Affairs, Jeddah, Saudi Arabia, King Abdullah International Medical Research Center, Jeddah, Saudi Arabia, King Saud bin Abdulaziz University for Health Sciences, Jeddah, Saudi Arabia, Emergency Medicine Consultant, King Abdulaziz Medical City, Jeddah, Saudi Arabia