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Oculogyric crisis (OGC) is a rare sudden, paroxysmal, dystonic reaction that may manifest in response to specific drugs, particularly neuroleptics, or medical conditions, such as movement disorders. This neurological phenomenon is characterized by a sustained dystonic, conjugate , involuntary upward deviation of both eyes lasting seconds to hours.
Some elements of the cholinergic crisis can be reversed with antimuscarinic drugs like atropine or diphenhydramine, but the most dangerous effect — respiratory depression, cannot. [ 6 ] The neuromuscular junction, where the brain communicates with muscles (like the diaphragm , the main breathing muscle), works by acetylcholine activating ...
Some cycloplegic drugs can cause dilation of the pupil for several days. The ones specifically used by ophthalmologists or optometrists wear off in hours, but when the patient leaves the office strong sunglasses are provided for comfort.
Spasm of accommodation is frequently resistant to treatment. However, some patients do find relief through the use of daily eye dilation with cycloplegic drops. One side effect of cycloplegic drops is that they often have BAK as a preservative ingredient, which, with daily use, can erode the tear shield:
Most drugs with parasympatholytic properties are anticholinergics. Parasympatholytic agents and sympathomimetic agents have similar effects to each other, although some differences between the two groups can be observed. For example, both cause mydriasis, but parasympatholytics reduce accommodation (cycloplegia), whereas sympathomimetics do not.
Cyanopsia is most commonly reported in older adults after cataract surgery, where symptoms typically subside within a few days to weeks as the eyes adapt to the synthetic lens. In younger adults, cyanopsia is often caused by medications like sildenafil, with symptoms disappearing once the drug's effects wear off.
Scar tissue can block the flow of fluids around the spinal cord. Fluid pressure may cause cysts to form in the spinal cord, a condition called syringomyelia. This can lead to additional loss of movement or feeling, or the onset of pain or autonomic nervous system symptoms. [6] In adults, onset of symptoms typically include:
Mouthwash and tooth brushing may have drying effects. [ 4 ] In the palliative care setting, anticholinergics and similar drugs that would normally reduce the production of saliva causing a dry mouth could be considered for symptom management: scopolamine , atropine , propantheline , hyoscine , amitriptyline , glycopyrrolate .