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Anti-tuberculosis medication-induced oculogyric crisis and the importance of proper history taking

Authors Wong LH, Tan E

Received 31 July 2017

Accepted for publication 23 September 2017

Published 13 October 2017 Volume 2017:10 Pages 341—344


Checked for plagiarism Yes

Review by Single anonymous peer review

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser

Lin Ho Wong,1 Endean Tan2

1University College Cork, Cork, Ireland; 2Tan Tock Seng Hospital, Singapore

Abstract: Oculogyric crisis (OGC), frequently caused by medications such as antiemetics, antidepressants, and anti-epileptics, is an acute dystonic reaction of the ocular muscles. It consists of wide-staring gaze (lasting variably from seconds to minutes), seizures, and a widely-opened mouth. To date, there have been no reports of anti-tuberculosis medications such as rifampicin, isoniazid, pyrazinamide or ethambutol inducing OGC. It is of utmost importance to recognize this adverse reaction, which could be incorrectly diagnosed as an anaphylactic-like reaction. In this paper, we highlight a case of a 66-year-old Indian man who presented with OGC induced by anti-tuberculosis medications which was initially suspected to be an anaphylactic reaction and was subsequently halted with the administration of diphenhydramine.

Keywords: oculogyric crisis, tuberculosis, rifampicin, isoniazid, ethambutol, adverse drug reaction

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