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1 病例介绍 例1 蔡晓萍 女 10个月。因阵发性头向后仰1小时,门诊以“病脑”收住院治疗。入院后追问病史,患儿因呕吐腹泻2天,曾在外院治疗,用灭吐灵5mg每日2次肌注。距末次肌注灭吐灵1小时后出现阵发性头向后仰,双眼凝视,每次发作持续2～3分钟,间隙5～6分钟,不伴发热、咳嗽、气急等症状。入院后体检神志清,前囟平坦 1.5cm×1cm,病理症阴性。排除病脑的诊断,考虑灭吐灵中毒导致锥体外系症状。（灭吐灵常用量不能>0.5mg/kg/d,本剂量已达1.2mg/kg/d）。立即停用灭吐灵,静脉输液促进药物排泄,用安定等镇静剂,补充钙剂抑制其症状发作,第2天锥体外系症状消失。
Case Description Case 1 Cai Xiaoping female 10 months. Due to paroxysmal head back 1 hour, outpatient “sick brain” admitted to hospital for treatment. After admission to ask history, children with vomiting diarrhea for 2 days, had outside the hospital treatment, with metoclopram 5mg 2 times a day intramuscularly. From the last intramuscular mephitis 1 hour after the paroxysmal head back, eyes stare, each episode lasts 2 to 3 minutes, the gap 5 to 6 minutes, without fever, cough, shortness of breath and other symptoms. Physical examination after admission Qingzhi, anterior bland flat 1.5cm × 1cm, pathology negative. Exclusion of brain disease diagnosis, consider out poisoning poisoning caused extrapyramidal symptoms. (Metoclopramide often can not be> 0.5mg / kg / d, the dose has reached 1.2mg / kg / d). Immediate withdrawal of metoclopramide, intravenous fluids to promote drug excretion, with tranquilizers and other sedatives, calcium supplementation to inhibit the onset of symptoms, the first 2 days extrapyramidal symptoms disappear.