Acute Jaw Dystonic Reaction Emergency

A young patient with autism has a medication related severe dystonic reaction involving his jaw. The acute dystonic reaction responded quickly to intravenous diphenhydramine. We are grateful to the young man and his mother for allowing this video.

[@Not_a_snake]

Thank you for getting his permission and talking to him, not at him. Disabled folx need autonomy too.

[@MsFuzzipoo]

I hate to say this, but THIS. The way the team spoke to him directly, instead of over him to his mom, was wonderful to see. They spoke _to_ him, got his permission, answered his questions, told him why they wanted to film him, and how it would help others. It was so uplifting to hear that! ❤️❤️❤️ I've usually had great docs/nurses at my local ER, with one exception: I went in for an acute dystonic reaction (not my first time at that ER, for that exact issue), and the doctor walked up, didn't acknowledge me at all, and asked me partner "Is she always like this?" I knew I didn't want to antagonize the person who would be treating me, but man... It took all I had to not call the doctor out and say "Hay! Look ap mah charpt, mofffahfukuh!" (it's hard to talk/swear when your tongue is protruding from your mouth 😉) Fortunately my awesome partner set the doc straight, and said doc finally started treating me like a person 🙄. I'm thrilled to see the team here treating this kid *as a person* because he is one, and deserves autonomy like everyone else!

[@Pharadeon]

Mr. Mellick, I wanna thank you for all the filming you do in your emergency department. This is not like a TV documentation or anything similar to that because you don’t put music in the video or narrate what’s happening in an overdramatized way. That makes it very informative and interesting. I am from Germany and I am gonna be an EMT and your videos are so motivating! Thank you!

[@lmellick]

Thank you very much! You don't know how much comments like this motivate me. PS: Spent 3 of the best years of my life in Stuttgart. Love Germany and the German people!

[@oneseeker2]

Doc, I am glad you are in planet earth! You're approach, bedside manner and knowledge is comforting!

[@lmellick]

Thank you kindly

[@krue1881]

God all i can think is just GIVE IT TO HIM. The most scariest and painful experience of my life. My whole body contorted, couldn't walk normal, couldn't control my face. It was hours of torture, spasms that would come and go. I was obviously scared and hyperventilating. Which did not help. Not one person in the ER took me serious but one nurse who had seen just one other case before took a guess at what this was. If it wasn't for him, I dont know what could have happened. Instead, 5 minutes after a shot of benydril and I was back to normal. I can still remember exactly what this feels like.

[@Texaslife98]

I was dismissed by nurses and doctors too.. I remember being in such pain.

[@cratersofthemoon]

Hugs to the Kid and Hospitality staff!

[@lcagee]

This ER doc is awesome. First of all, he recognized the problem: a dystonic reaction to Risperdal. Then he knew exactly what to do about it: IV benedryl. Then he explained things to the mom and kid and asked if he could film it to educate the rest of us. And he had a great bedside manner. The first time I saw this moonlighting in an ER, I did not recognize it immediately. The patient complained of her throat closing up as I recall and I was concerned about epiglottis. Finally a light went off when I realized she was taking an anti emetic, compazine. Until you see a dystonic reaction, the clinical presentation may be confusing. Always think of drug side effects when working in the ER.

[@kellydavis2154]

Thank you Dr. Mellick and the patient/his mother for this video. Very helpful for medical students to see these cases while studying in our books.

[@ShinigamisBlade]

I remember learning about this in pharmacology. My professors always stressed to watch for this and the other side effect as it can look like the patient is having more psychiatric issues and some were given more doses instead of the right treatment. Thank you for the education video and the importance of taking a good history and knowing your medicine side effects!

[@Fenodyree]

This just happened to my son last night and it was terrifying. We went to the ER not knowing what was going on. Thank you for posting this video!!!

[@AltairKasem]

Wonderful video as usual. I'm a med student in Romania and learning a lot from your videos! Thank you so much!

[@lmellick]

Excellent. So glad to hear this. You are welcome.

[@nimlham1573]

Thank you Doc. You're helping a lot of students like me .

[@lmellick]

Happy to help

[@meowjakx3]

Dr. Mellick, thank you for all of the educational videos you produce in the ER. I am a medical student and these videos are very informative and helpful! Your team is amazing.

[@GravityGamerXCII]

What a brave young man

[@MsFuzzipoo]

Thank you for this video. I feel so bad for that kid! I've had five dystonic reactions myself ( I'm *very* sensitive to Antipsychotics- both 1st Gen and the newer ones). I've had difficulty explaining/educating others about how awful acute dystonia can be: it's extraordinary painful and frightening, every time. I'm saving this video to give people an idea of what it's like. Your team took great care of that kiddo, and I want to thank you for that as well. It was such a relief to see him pain free and back to his regular self! I also appreciate that you took the time to speak to him directly about what happened ❤️

[@lmellick]

You are very welcome. Thanks for the thanks!!

[@balckbettystack]

Read the comment I left. I feel for you, as this has happened to me too. 1st generation antipsychotics also. It was Stelazine that caused my attacks. It annoyed me so much the treatment, or lack thereof, that I received at the time. Plus I didn't need the medication anyway. I had undiagnosed severe PTSD and was being punished for wasting their time with my "games".😤😡😤🤔

[@jordanchurch5727]

Such a sweet boy. Thank you for sharing this, wealth of information!!

[@crystalwallace2175]

Ain't he though! Little sweetheart ♥

[@michelemurphy3541]

He has definitely helped other people understand what this is! He is such an awesome kid!!!! Super super bright! I hope he is well and living a wonderful life~such a smart kid!! 💫💛

[@vianeyangeles4808]

This happened to me but my mouth would clench and my neck would tilt backwards Scariest shit ever.

[@P0RTAL_DARKO]

@Quentin Mallard That same medicine caused my whole body to shake uncontrollably/ my heart to race.

[@KishBish]

same.. from a shot of compazine

[@balckbettystack]

So many years ago when I was started on a new medication, I feel asleep on my arm. When I woke up, my arm was feeling extremely stiff. It was so intense and felt so weird that I mentioned it to another patient. Thank goodness I did. Within a few minutes, the stiffness had moved across my chest to the other arm, and rapidly up into my neck. Making it extremely difficult to breathe. Freaking out, I tried to walk to the nurses station only to find that now my neck, spine, legs, toes and feet were contacting too, twisting my whole body into a position I could never, ever get into. By the time I waddled to the station and tried to get staff attention, my whole body from the tip of my head to my toes had intense, non-stop spasm and I was in extreme pain. I couldn't speak a word and all I could do was cry as my body got more contorted. But finally someone came to help after the other patient I had spoken to got their attention. However they tried giving me a tablet which because of the position of my neck twisting down, sideways and back, plus I couldn't close my mouth, I couldn't swallow it. They just kept on putting it back in my mouth a few times before they got so annoyed (like I was doing this on purpose), that they finally gave me a Cogentin injection. That took a few minutes to take away a fair bit of stiffness. It occurred again the very next day before they decided that I was better off without the medication setting it off. I have NEVER experienced anything like that. Childbirth of 78 hour's with no pain relief was less painful. And at least you got a break every 45 seconds for a minute. But not that. I wouldn't wish it on anyone.

[@MsFuzzipoo]

I'm so sorry you went through that... I've been through it 5 times but it usually is confined to the areas above my shoulders. When it did affect my whole body (just one time) I couldn't walk, but from my neck down I didn't feel painful spasms, just uncontrollable shaking and weakness. Luckily I made it through the ER doors right before it happened and I already had my partner holding me to guide me in (it's hard to walk when your neck muscles stretch your head back so far that all you can see is the sky) and a nurse was nearby to grab me and help hold me up. I can't imagine having that spasming pain EVERYWHERE and the panic of trying to move and communicate in that state (I was VERY lucky to have my partner with me to clearly explain the problem...). Ugh. I'm so sorry. I'm ticked that the staff treated you like that. Why they didn't give you the injection right away is... bizarre. It can be dangerous to try to swallow in that state, and pills don't provide the quick relief of an injection/IV dose. I've had to wait for oral meds to kick in during my first episodes, because I could still swallow somehow... I don't recommend it. Injections/IVs take a few minutes but it's way better than half an hour. I've never gone through childbirth, but acute dystonia has been the worst pain I've felt. I have a number of issues that cause chronic pain, and can handle a lot, but dystonia spasms are something else... When I'm asked to rate pain on a 1 to 10 scale, dystonia is definitely what I consider a 10. I'm really sorry you had that awful experience. I hope you're doing well now.

[@balckbettystack]

@@MsFuzzipoo Thank you so much for your understanding and kind words. I'm extremely lucky that I only had those two incidents. But that was enough. The staff in that hospital were uncaring and barbaric. They didn't trust many people to take their medication, so they would give it in liquid form in a cup of tea. The problem with that was that the tea was made with loose tea leaves and they would make sure that you drunk the whole, entire cup. Which included the tea leaves. It was the late 80's and psychiatric hospitals were not exactly the best places to get well. So the treatment that you received was far from sympathetic, kind, caring and empathetic. They were cruel at times and had so many rules that they wouldn't bend on. I believe that my episode annoyed them as they actually had to come out of the nurse's station and do some work. Plus, psychiatric nurses back then held either just a plain psychiatric nursing qualification. Or a few were general trained registered nurses who did additional psychiatric nurse training. So there was a great lack of misunderstanding on behalf of the psych only trained staff about pain and what to do when someone can't physically swallow. They could deal with someone refusing to swallow but not because of muscle contractions. I ended up in many hospital's over the nine years that they couldn't work out that I had PTSD. And I suffered abuse to varying degrees at many places. This was my first experience though of what was to come in the future. I hope that your attacks ease up. At least you know what is happening now and have your husband to help you.

[@penyarol83]

@@balckbettystack horrifying, the psych "profession" has SO much to apologize and atone for. There is just no excuse for such cruelty, barbarism, ignorance and indifference. That these people get degrees and get paid to inflict these tortures is just beyond. Pathetic and mind-boggling.

[@balckbettystack]

@@penyarol83 If it wasn't for a psychiatrist and a psychologist, I wouldn't be here at all now. It happened to be a psychiatrist that realised that I had PTSD not everything else that they diagnosed me with and tried unsuccessfully to treat. And a psychologist, who taught me how to live again. But, yes, I have to agree with you on the point that many of the psych nurses back then were uncaring. I'm actually not sure why they got into the profession? I know I became a nurse because I enjoyed helping people in need.

[@penyarol83]

@@balckbettystack there are good ones. But there are many, many bad ones. The field itself needs a complete overhaul.

[@talenajordan7003]

What a sweet, brave little boy! Hugs and prayers for him!

[@bernardshearing3202]

I really enjoy your videos. Seeing things like this reminds me of just how fast life can change.

[@lillian758]

Poor baby, I feel so bad that he has to experience this.

[@neeki8367]

Doc you are awesome to share this, thank you the the little brave patient too

[@Nativestyles]

I had an acute dystonic reaction with Haldol. My whole body spasmed so badly. You would thought I was at the end of having tetanus. I was given Benedryl. In a matter of seconds, my whole body relaxed. I don't ever want to experience that again.

[@thinlizzie435]

Same thing happened to me on a psychiatric ward, the nursing staff refused to give me procyclidine for 3 days and I was in unbelievable pain, my jaw locked that tight I bit through my tongue and the nurses claimed to my psychiatrist that I bit my arm, sucked the blood out and spat it out implying that I was lying about having dystonia. Disgrace. I had to stuff toilet paper in my mouth to minimise the teeth grinding and I couldn't eat. What was the most painful thing about was my jaw would lock side to side and then clench while my teeth were overlapping each other.

[@Nativestyles]

@@thinlizzie435 omg how awful. I would have sued for this. Could you still? This is wrong on so many levels.

[@thinlizzie435]

@@Nativestyles Technically I could but it would hard to prove because the nurses would all band together and become tight lipped. Haloperidol is a hell of a drug.

[@MonolithicCyanTsunami]

@@thinlizzie435 dude I'm so sorry you went through that, and for three whole days I can't even imagine. I went through it for a couple hours before they administered a benadryl shot, I thought my jaw was gonna break off. I hate halperidol (I can't spell it right sorry) When I started to have the problem I went to the nurses desk and told them I was having issues not being able to control my muscles. I ended up falling to the floor because I was in so much pain and I couldn't stand up right, my back was twisting and my neck was stuck back I couldn't straighten myself for the life of me, my arms were stuck out too, I remember the pain in my shoulders and spine was unbearable. At first the nurse didn't seem to believe me, she told me to get off the floor and I was crying telling her through my locked jaw that I literally couldnt. It was so embarrassing bc this was happening in front of everyone at the psych ward, some nurses came out to help me to my room and I asked if I could step in the shower because I was sweating so bad. I literally just got in while I was still in my clothes, I couldn't get off the shower floor and really didn't want to but they helped me get out, get into dry clothes, and layed me in my bed to wait for a benadryl shot in my ass. Anyway sorry to ramble so much I'm just glad that I'm not the only one who went through that shit

[@Nativestyles]

@Frozen Art! 🎨💙 it could happen to anyone.

[@artemiddle]

Thank you for sharing all your videos! I am neither a doctor nor a student but I like your content very much!

[@lmellick]

You are so welcome!

[@paulnyende6389]

Thanks Dr for this Video. Am a Psychologist from Uganda,. I have a 23 year old son who had similar symptoms while on Risperidone. He is autistic. It opens up my mind. I took a video and would be glad to share it with you with his consent. Thanks to mom and the young man who have given us this opportunity.

[@lmellick]

I apologize, but I am just seeing this comment. I would be glad to see this video.

[@emidiezdelasierra9694]

I suffered from this from a shot of Haloperidol for a panic attack and it was the worst pain I've ever suffered BY FAR.

[@abbiejomakin4349]

Halaparidol is the worst caused this in me to my jaw is still numb 3 days later from pushing to the side

[@Saving_Money10k]

I had dystonia /tardive dyskinesia which prompted me to jump into highway traffic. Breaking my ribs. Collapsed lung and broken ankle tear grade 3. Antipsychotics are no joke. It lead me down a dark road

[@JoelWelter]

The first time I ever saw this was a young lady (20's) who worked in our ER and had torticollis presenting as a unilateral sternocleidomastoid (only) spasm due to a new medication reaction. It really scared and embarrassed her when it occurred. Diphenhydramine really worked quickly (seconds) and she was back to normal. It's the easy wins that can make the day tolerable.

[@danielgood]

I just had this happen to me. My jaw would open all the way up and my throat closed up. It was so painful and scary my throat wouldn’t let me breathe and my jaw hurt so bad. Pretty awful.

[@clairerichards4936]

This happened to me three times in my adolescence. I was taking medication for ADHD. Instead of my parents taking me to the ER, they just prayed for me until the episode stopped. They took that as a sign that their prayer worked, so they didn't take me in right away and wrote it off as demon possession. Only when I asked to go to the doctor afterwards did they take me, but the doctor couldn't figure out what we were describing and just prescribed some muscle relaxants. The next two times it happened, I wasn't taken to the ER, they just prayed for me until it stopped and I never got treatment. The last time it happened was 5 years ago and I haven't had an episode since. I had changed medications in that time so maybe that's why it stopped. But I never knew what it was or what happened to me until today. I've been puzzling about it for years until now.

[@amyp8162]

Hope you were able to escape their abuse

[@clairerichards4936]

@@amyp8162 I don't blame them or hold a grudge. They are very loving parents and did what they thought was right. I just wanted to tell my story because I was baffled to only be finding out now. I love my parents and after I told them that I found out what it was, they were very grateful to finally know what happened and they were happy to know I was no longer taking the meds that had caused it to happen. But I appreciate the sentiment behind your comment anyway, and I know it was not meant as an insult. 🙂

[@panunkashmir6518]

Which medicine doctor prescribe you... My father is also suffering this...he take ticstop and pacitane medicine but have no effect on it....

[@clairerichards4936]

@@panunkashmir6518 I was taking Adderall at the time. Once I switched to Concerta I was fine.

[@Texaslife98]

We lived the exact same life..

[@amazinggrace3207]

Poor kid. Magic medicine.

[@jasonk4348]

This is awesome man. Thanks to this brave kid man. This looks like a nightmare man..

[@lilvoicemail5738]

I had this from abusing DXM it was hell and I will never try it again

[@MsFuzzipoo]

It is. I've been through this five times as an adult, I can't imagine what it's like for a kid! My heart goes out to him, and I hope he never has to go through it again. It's scary and painful.

[@jasonk4348]

@@lilvoicemail5738 DXM is so 2008 bro wtf are you doing killing ur brain cells. Also it fucking deteriorates your body, you'll be a stick. Trusttt me

[@gary_gniokers]

Man

[@mydyisgod]

Oh bless his heart.

[@dastrnad]

Poor baby! I feel so bad for him.

[@Saving_Money10k]

Been where this gentleman is before. Was not fun at all so traumatizing

[@Posh2.0]

I was in the ER for nausea and was given Reglan- within minutes, I started screaming and trying to get off of the hospital bed. I was begging the doctor to help me- it was the worst 2 days of my life. I was suicidal, which I’ve never been before. And couldn’t control my body movements- the o my reason they gave that to me is because I was breast feeding otherwise I would’ve gotten fernegan

[@jessicaloveland4034]

Same thing happened to me

[@vV0772]

I took risperadone a while back and I had a very similar experience as the kid- I couldn’t control it -IT controlled me and at the time my speech began to slurr. I had uncontrollable movements VERY SCARY. I stop using it for the better I hope nothing like this EVER happens to anybody else

[@finessinit.2110]

Happened to me to, because it resperidal aswell

[@finessinit.2110]

Are you still on any AP’s? I’m in invega and it’s HORRIBLE, took away my emotions

[@LS-kx5vj]

These drugs areliterally evil at times

[@MsFuzzipoo]

Risperdal did it for me, too (and Haldol, and Latuda). I'm really sensitive. Lucky me! Fortunately, Seroquel works wonderfully, and doesn't send me to the ER with dystonia...

[@askhowiknow5527]

Poor fellow. He’s a trooper ❤️ Maybe he’ll be a doctor some day

[@joanna7538able]

Great video Doc! I get dystonic attacks when like I'm in the hospital and they mix medications once I was put on a couple of medications I can't remember the combination now but it gave me a major dystonic attack where my arms just kept stretching on their own and it wouldn't stop which led to my legs doing it and within like 10 minutes my whole body was was doing these stretches that I couldn't control & muscles in my body were aching and stretching so long and hard and then I start to shake and cry. I was 30 years old. Its happened 5 different times. I'm glad that has not happened in a long time. Last time it happened a ambulance had to pick me up & take me to the hospital it was my gallbladder. So the medications they put me on mixed with the medications I was taking for my colitis somehow mixed together and made me have the dystonic attacks.

[@MsFuzzipoo]

Sorry I didn't see your comment until now! I'm also sorry you went through that dystonia hell (and even while dealing with gallbladder pain!!!)... It's SO painful and exhausting, but you can't stop, and resisting can make it even worse... ugh. The first reaction had my neck and jaw spasming/stretching/twisting for hours over two days. It stopped overnight when the ER gave me Benadryl but came back when that wore off as my partner was driving me to my Psychiatrist. My Psychiatrist immediately gave me benztropine and within half an hour it was over. Afterward I was so happy I could eat 'cause I was starving... but the muscles in my jaw were so weak and tired: I'd chew a few times and then was unable to keep chewing or move my jaw because it was fatigued! I ended up using my hands to move my jaw around and "chew." It's such an awful and bizarre experience, and I don't like that you went through it 5 times too, but it's nice to find someone who understands. I was about 30 when my reactions happened, too (maybe a year younger or older, I can't recall right now). I'm on a few meds, and was taking them at that time... I've read that one of them (effexor) can increase active levels of some medications when taken simultaneously (it's believed to slow down the body's ability to metabolize certain meds, including haldol, which is what caused my first dystonic reaction), so your med interaction issue makes me wonder even more about that... I mentioned the potential Effexor interaction to my Psychiatrist. He hadn't heard about it, but I'm not surprised. Sometimes doctors and medical professionals only find this stuff out after hearing similar patient experiences... like when they found out how awful discontinuation symptoms are for Effexor. The discontinuation issues are why I'm STILL taking it today. But that's a whole other story. Thank you for bringing your experiences to my attention. I hope you never deal with dystonia again! ❤️❤️❤️

[@d3adbugg]

@@MsFuzzipoo I've read several of your replies to comments on this video because I've been experiencing this for a little over a year.. and out of all the shared experiences in this comment section.. you are the only person who's mentions Effexor playing a role... And it's side effects coming off Effexor caught my attention, but one thing at a time.. Is there any way we can have a private chat, ema il, telegram, morse code, message in a bottle, or anything?

[@chaoswitch1974]

Some crazy things happen that I wasn't even aware could happen!

[@amandakrasna5300]

What a brave little boy! ❤️❤️❤️❤️❤️

[@sweb3590]

Poor sweet boy Awesome staff

[@k.d.kelley2830]

I had this year's ago from a drug reaction. My jaw would also clench shut( I thought my teeth would break) then my neck rolled in clockwise and then counter clockwise directions. Also the entirety of the trunk of my body would twist in the same way alternating clockwise and counter clockwise. I really thought I was dying, it was terrifying. I foolishly didn't seek medical treatment and eventually passed out in my bed from sheer exhaustion. Don't ever take a pill or medicine that your unfamiliar with, or isn't meant for you. I did , and this is what happened.

[@perfectlyhonest4139]

I am nurse. I find your videos interesting. 💕 subscribed

[@lollipopnails6634]

This happens to me since I was a kid. I had my jaw wired shut because no dr knew why this was happening. It didn’t help. Also when I had these “attacks” my eyes would want to look up at the ceiling. I’ve tried eating and could only close my mouth briefly, which means I couldn’t swallow the bite. I couldn’t even swallow my saliva. Benadryl is the only thing I found to help me.

[@MsFuzzipoo]

I hate to offer unsolicited advice, but having been through this myself I'd feel bad if I didn't ask: Have you tried Cogentin (benztropine)? I had numerous dystonic reactions and benedryl worked temporarily but would wear off to quickly, and the dystonia would come back. The ER finally started giving me Cogentin (with Ativan), and that did the trick. I ended up getting an RX for Cogentin, and it works wonderfully by itself, without Ativan. I experienced the same thing with the eyes, and during dystonia I doubt I could even keep food in my mouth (my tongue sticks out of my mouth and I have no control over my jaw, and swallowing is incredibly difficult). I'm really sorry you have to go through this ❤️

[@Rahfyousef1545]

U r great doctor u helping so many doctors and pharmacists to see real cases

[@nicolejackson7212]

Aww poor little guy I hope he feels better

[@jesuslima4380]

Medical student understanding this pathology! thank you for the demonstration, very educational !

[@lmellick]

Cool! You are welcome!

[@cathylimas9716]

God love him. Precious little guy. He's really trying

[@wayfordford4889]

IVE suffered from this a girl gave me pills when i was a teen thinking it was something good , my jaw did that, my nana called the ambulance, when i got to the hospital they yelled at me and thought i had mental illness . and told me to stop it, it went away after some time but i never got treatment

[@KishBish]

OMG they didn't give you benadryl or anything??

[@seeithookit7643]

No way for real

[@chaoswitch1974]

Wtf?!

[@k.d.kelley2830]

Same thing with me.

[@Texaslife98]

Exact same experience I had.. I swear so many doctors/nurses have the IQ of a potato. I was able to find out what I had suffered from years ago with a quick google search.. yet they can’t find the right diagnosis after years in medical school. 😤

[@anastaciadawkins8912]

Happened to me after I was given compazine for nausea after surgery...so scary....

[@genregaming9643]

I have also faced dystonia after taking Respiridone injection. This is the most worst uncomfortable situation faced in my life 😢😢😭.

[@katie0698]

poor baby. medications are wild bro

[@pamelaflirtyskunk7698]

Poor guy! I hope they are able to keep this from happening again. I've had muscle spams and they are incredibly painful. I can't imagine having it in my jaw.

[@JustME-zn2vu]

I was on a medication that did that to me too and it sucks

[@kinseymcelhaney7326]

I had this the other day, it was the worst experience I’ve ever had

[@Stone8age]

Poor kid, too bad that they haven't yet came up with better drugs.

[@nicolejackson7212]

I feel so sorry for the little guy. I hope you feel big Nicole Denise Jackson

[@nicholemiles8847]

Poor guy. Makes me sad.

[@bkr1895]

I’m bipolar and went through a series of medications that caused me to have dystonic reactions. It would cause my jaw to painfully pull to the right side. It was terrible it felt like someone was trying to rip off my jaw. I really feel for this kid, these episodes were the absolute worst pain of my life, it was so bad I seriously considered taking a knife and cutting my masseter just so it would stop, I wouldn’t wish it on my worst enemy.

[@nuggetfarm7866]

this happened to me for the same reason it’s genuinely the worst pain i’ve experienced i’m sorry it happened to you too

[@jennipaaskysaari5111]

So good that you made the video. My son has similar diagnosis and difficult behavioral issues, and we are considering Risperidon for him.

[@donnawoodman6249]

I suffer from Laryngospasm occasionally, once during a nasty cold I passed out during an episode. I don’t remember it happening and I’m glad but when I came to it scared the hell out of me. Just a quick breath in can trigger it.

[@drsagsalot608]

This happened to me when I was wrongly prescribed haldol (I was 15 and 85 pounds, 5’0) my jaw would clench so hard my teeth hurt and my eyes rolled up so far I couldn’t see properly. I was drooling all over the place and the hospital refused to give me anything because they thought I was faking it. They injected me with Benadryl and I still had a bad reaction, I was in the hospital for three weeks.

[@JustChristianThings]

This happened me too, in a mental hospital i didn’t know what was happening to me I was so scared and it hurt so bad. I tried going to the nurses to help and they just yelled at me telling me to close my mouth. (I thought it was obvious I couldn’t it was out of my control) idk why they would think I was doing that to myself that still makes me so mad to this day. Wtf. I was begging them to let me go to the ER. they treated me like I was doing it to myself on purpose. I feel like I should have sued them I was suffering in pain and terrified not knowing what was happening to me. I was having a really bad reaction obviously you don’t have to be a nurse to see that. It was patient neglect.

[@Texaslife98]

The exact same thing happened to me.. I made the mistake of using a vape when I had an exposed nerve in my mouth and this condition started. The nurses didn’t believe me at all.

[@dmitriyv4557]

Thanks, like your work.

[@lmellick]

Many thanks!

[@AQHAbuckskin]

I had this multiple times. It literally looked like I was having a seizure. Come to find out since I have pancreatitis and I am always on different nausea medicines that was causing me to get the dystonic reaction. Literally every nausea medicine causes me to have dystonic reaction. Even Zofran. It is beyond painful.

[@michaelmaggio4923]

So I started having these symptoms about a year and a half ago and they’ve gotten progressively worse and more frequent. And in my small town finding a doctor or PA to even take me seriously let alone properly diagnose whatever it is has been challenging. Plus the nearest hospital is like 45 mins away. Idk if you or anyone has advice to help me I’d be beyond grateful. This is starting to impact my life very seriously.

[@lmellick]

Maybe try taking oral Benadryl and see if that helps. You might have tardive dyskinesia which might be harder to treat.

[@ladyjennifermathews5096]

so sad. i been dealing with this from antipsychotics i havent had the jaw but in my ribs and back. praying for a cure.

[@sazerchu]

I do too with my invega injections. The doc prescribed oral cogenten for me as a preventative before and after the shot and its never happened again.

[@ladyjennifermathews5096]

@@sazerchu they did prescribe me cogentin but it has not been working

[@sazerchu]

@@ladyjennifermathews5096 Oh jeez/ That must suck because they don't really have much besides cogentin or benadryl for that. At least yet. AT that point its usually swap meds to something else and you play chemistry until you find it... Im prayin for ya mis nonetheless.

[@mass131987]

thank you for such a great informative video👏🏻

[@HN-li5cf]

Miss the drama?

[@borntobewilddz]

be aware of Meige syndrome at the begining it may present as a jaw spasm then becomes hemifacial spasm

[@bok..]

Of course, in this case its directly linked to the atypical antipsychotic

[@Mike-gk7pk]

I had something similar. But my jaw went to the side. It hurt so bad. It happened after taking medication for panic disorder called Thiothixene.

[@mattsvoid]

Do you still have them?

[@Mike-gk7pk]

@@mattsvoid not anymore. It stopped within a few weeks after stopping the medication.

[@bkr1895]

Same but for me it was for bipolar, it was on Latuda and Rexulti when it happened to me. I wouldn’t wish it on my worst enemy. The worst pain I’ve ever felt hands down.

[@coolliger]

Poor kid, hope this never happens again. Is there any evidence of Botox treatments for prophylaxis? Sorry if this is a dumb question; I'm a scribe for a neurologist and witness a lot of Botox for chronic dystonia. I wonder if Botox could prevent acute reactions.

[@bok..]

I would say in the case of medication induced ones like this it wouldnt be recommended as its an acute reaction.

[@Starship245]

Thank you for this video !!!!!

[@vaughncurtin6660]

I get reactions at times from antipsychotics but thank theord Benadryl shot helps

[@ronishanicole490]

I had this before from haloperidol and another medication causes tongue issues as well also messes with your breathing psych medicines does this to me every time especially the two meds that I named horrible feeling now I know what it was thanks

[@BABYDOLZ]

oh this is painful. I get it with a toung that spazes, a neck that turns to the right and eyes that deviate to the right. This even after Benadryl akes because the muscle a tightened for so long

[@KishBish]

a shot of compazine had me so messed up with a dystonic reaction.. I thought I would be that way forever! scariest days of my life.. thank God for benadryl 🥴

[@MonolithicCyanTsunami]

ME TOO! I remember thinking I was going to be stuck forever, I cried with relief when my doctor said it was reversible

[@KishBish]

@@MonolithicCyanTsunami YES!! it was horrible!

[@claired1932]

Compazine is what caused mine! It was so scary I got help quickly as I was admitted when it happened!

[@KishBish]

@@claired1932 yep same! I spent the night in the hospital with benadryl injections.. it was crazy how I didn't feel the side effects until a few days after the initial compazine injection.. I started having a hard time swallowing.. then my speech was affected.. talk about scary!!

[@claired1932]

@@KishBish I've had drs try to use it since even though I've said I've had a reaction to it!? I am terrified of it and you know phenegren and reglan also are similar!? I have never had it happen again and don't want it to! Terrifying

[@fiji1jay]

My prayed go out to u man head up

[@cigiss]

is he having extra pyramidal sd after the risperidone?

[@bosshog31216]

Wait geodon did this to me when I was about his age and a couple of years later I got on Haldol and felt it worse all over my muscles it will look similar to a stroke smh but I got on a cogentin and it worked for the acute reactions

[@claired1932]

I had this happen to me in the 90s on compazine during pregnancy! It too was immediately resolved with Benadryl! 4 hrs later it happened again and required a second dose of IV Benadryl.

[@Oliver-st7ky]

@Dr. Mellick... How quickly does the IV diphenhydramine work for Dystonia? I am assuming the IM route would also work, but obviously IV would be much faster (im just thinking about peds pt's and fear of IV's). Was a standard 25-50mg bolus utilized? As a side note, I know when I have received IV diphenhydramine, the nurse pushed it undiluted and "slammed it". I was having an anaphylactic reaction.... so that was probably necessary... BUT I immediately coughed and my arm BURNED like nothing I have ever experienced (similar to propofol without lidocaine). Is it your ED policy to dilute the diphenhydramine or push it over X minutes? I always dilute 1ml of diphenhydramine in 9ml of NS and push over 2-5 mins as tolerated. If the PT is particularly sensitive, and the infusion isn't particularly emergent... I place 50mg in a 100ml NS piggy back and either let it gravity flow or attach to a pump and run over 10 - 15 mins. What are your thoughts on this?

[@zebra4145]

When Benadryl is pushed to fast it burns your throat and veins, which is normal when being pushed to fast. You suppose to push it slow and dilute it. I dong think you where having anaphylactic I think it was pushed way to fast. I’m so sorry that happened... I have dystonia and the Benadryl work in minutes.

[@habib080]

Great video. I didn’t know you worked in South Alabama. Always thought these videos were coming out of Georgia.

[@lmellick]

I moved here two years ago from Georgia.

[@habib080]

@@lmellick awesome. Stay safe and keep saving lives =)

[@SaladRostrum]

I work with a lot of men who use steroids and abuse stimulants and they've all reported that supplementing their diet with 2-3 g of taurine relieved them of their muscle cramps. They do also abuse beta agonists which aggravate the cramps as well.

[@artemiddle]

Does high functioning autism really has a treatment? I couldn't hear the name of the first medicine, but why was risperidone used? I used it myself but I never thought I could have any effect on autism.

[@lmellick]

I am not an expert on treating autism. The new medicine was Adderal. I assume there could have been some attention deficit disorder issues.

[@artemiddle]

@@lmellick oh ok, thank you very much for your reply!

[@penyarol83]

@@lmellick Adderall isn't "medicine," it's a stimulant drug not too different from what people buy on the street. AKA kiddie speed or kiddie cocaine. We are drugging up children (and adults) in order to fit them into situations that are not good for them. Please. Let's drop the euphemisms - and the hypocrisy, as peasants go to jail for possessing similar substances as what doctors hand out like candy and pharma companies get rich off of - and be more honest about what's really going on in "medicine."

[@samifjs34]

What is the cause of it? And treatment?

[@abuzercortsuzlugil9035]

a lot of things can cause this, mainly typical antipsychotics such as haloperidol (haldol), chlorpromazine (thorazine) and certain antiemetics such as metoclopramide cause dystonia. treatment is anticholinergic drugs such as biperiden (akineton), diphenhydramine (benadryl), benztropine

[@hleighj]

Compazine too

[@dr.escargon]

Medication. Antipsychotics. Lots more.

[@alvi78]

benztropine anyone?

[@MsFuzzipoo]

YES YES YES! I was initially given diphenhydramine during my first episodes. It worked temporarily, and then the dystonia came back the next day. Cogentin/benztropine works _wonderfully_ for me, and others I know. I assume there are reasons it's not a first-line treatment for dystonic reactions, however, I don't know what those reasons are... Man, when I was finally given benztropine I was so grateful, but also ticked that it wasn't given to me earlier!

[@andyrojas9387]

@@MsFuzzipoo I have orbicular dystonia

[@madisynportorreal7020]

that is so sad

[@elbertarrobang5883]

that's also my pain what is the name of the medicine I hope there is a reply

[@sebeng4711]

american physicians give a drug called “benadryl” given through a vein. a different drug may be used depending on what country you are in.

[@jonathansims525]

Benadryl is the common/brand name for Diphenhydramine.

[@andyrojas9387]

I have orbicular dystonia, it is same as this

[@davidselke]

Why in God's name would a kid his age be on Adderall and Risperdal at the same time!! Im not a pharmacist but to me that sounds like A LOT of strong prescription for a child to be on!

[@jennipaaskysaari5111]

I dont know for sure, you have different names for madications over there. But at least here in Finland some children need both adhd medicine f or concentrationand risperidon to make them less volatile/aggressive/violent. I havent yet agreed to this with my son, but that has been suggested by his doctors.

[@reneecostsanzo2545]

Ok so this happens to me with other symptoms I can't swallow I can't talk I feel like I can't breathe my face and hands feel like they're on fire. I get it when I take my trileptal..... Any feed back would be great.

[@everydaydave]

So are patients who come in with a dystonic attack, so they have Dystonia?

[@rsxtypesmobbin8661]

Mann,poor kid!!That is screwed up the "doc"didnt give the diphenhydramine Immediately to this child...I just got out of the hospital from being Hella sick,so I got a shot of Zofran and felt out of it and so uncomfortable in my body,then the worse my jaw starting grinding my teeth, I had to physically hold my mouth,it,Was a Hell of a experience and the nurse came in with the benadryl and straight into my i.v it went and slowly that shit started going away.Again terrible and and I'm a man, this kid is young and should of got a shot ASAP.Have a great day everyone✌️

[@Texaslife98]

I’ve been there; it was one of the worst pains I’ve felt.

[@AkathisiaWarrior]

Man, where were you when I had to go to the ER for Akathisia?

[@pleunitentij4264]

I got this reaction then Worse to haldol nasty stuff!!!

[@sbpriesthood]

thank fucking God i took my mom’s haledol (don’t ask why) and experienced the suffering of it before being prescribed it in a mental hospital. i said FUCK NO!!!

[@crystalidx]

You're lucky, I should have never taken those drugs in the first place.

[@DanKoning777]

That suffering will seem like one of the best days ever compared to the consequences related to using Gods name in such a vile way. Please-while there is time to do so: "Seek the Lord *while He may be found.* Call on Him *while He is near"* [Isaiah 55 v6]

[@DavidR_192]

@@DanKoning777 - No-one here needs selling religion. Take it elsewhere. This is SCIENCE helping people. Where is your god while kids suffer like this?

[@DanKoning777]

@@DavidR_192 // You're right; no one needs to "sell religion" but that's not what I'm talking about. Why would I when most people already believe that "religious good works" earn favor with God, and gains gets them into heaven even though God said that's NOT possible [Gal 2v16;3v10-11/Eph 2v8-9]? As for "SCIENCE" helping people-right again. So question: since "SCIENCE" has proven that the laws which "govern" *all things* [physics, science, nature], *cannot* write themselves; then how can they even exist without a "law giver?" Where did these governing laws originate?

[@lilvoicemail5738]

Can this happen from dextromorphan abuse?

[@LS-kx5vj]

Yes sweetheart believe you me I was like a cross between the elephant man and the fuckin hunchback of Notre Dame!

[@nadadenada319]

No

[@lilvoicemail5738]

L EW I had this happen when I took 500mg but not 120

[@nadadenada319]

@@lilvoicemail5738 it doesn't because dxm is a nmda antagonist. And dystonic reactions only occurs on drugs whit antidopaminergic activity

[@lilvoicemail5738]

Nada de nada it can block antidopaminergic activity and the hospital labeled it a dystonic reaction

[@sectech221]

Wow. I’ve never seen that before. Now, would oral over the counter Benadryl work in similar fashion? Obviously not as quickly as an intravenous dose but in my mind it would work just as good. It’ll just take a little longer.

[@lmellick]

Yes, it would work, but not as fast.

[@NicoleAnnaTurner]

No, the pills don't work. I gotta get iv benadryl. Don't waste your time. Go get iv benadryl.

[@shapeshift13]

Psychotropics are poisons

[@Dranamolous]

Don't spread medical disinformation on a medical channel