Oculogyric Crises: an underdiagnosed condition
DOI:
https://doi.org/10.34024/rnc.2025.v33.20100Keywords:
Dystonia, Dopamine, Receptors, Antipsychotic AgentsAbstract
Introduction. Dystonia is a hyperkinetic movement disorder characterized by abnormal postures of a twisting nature or repetitive movements. Oculogyric crises (OGC) are a specific type of dystonia compromising extraocular muscles. Although rare, OGC can cause great diagnostic difficulties. Objective. To perform a narrative review of OGC to draw the attention of neurologists to this debilitating condition. Method. We performed a non-systematic review of published papers in English or Portuguese through Google Scholar from 2000 until 2025 using the terms “oculogyric crises/oculogyric crisis” or “crises oculógiras”. Results. We obtained a total of 239 manuscripts about OGC. Thirty two papers were selected for this review. OGC is an infrequent focal or segmental dystonia affecting extraocular muscles. Classically attributed to the acute use of dopamine receptor antagonists, it can also persist with chronic antidopaminergic use. Of relevance is the finding that new cases continue to be reported, despite the use of new atypical antipsychotic agents. Besides antipsychotics, OGC arises from the use of antiemetics drugs and drug therapies for parkinsonism. Other neurometabolic, genetic and structural conditions are responsible for some cases. It represents a diagnostic challenge due to its short duration and its similarity to other serious conditions as epileptic seizures and encephalitis. Treatment is based on the administration of anticholinergic or benzodiazepine drugs. Conclusions. OGC is an infrequent disease that can be caused by drugs routinely used in Neurology. Neurologists should be aware of its occurrence and causes in order to make a rapid diagnosis and suppress the causative agent.
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References
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