Extrapyramidal syndrome - anaesthetist’s challenge: A case report

Extrapyramidal syndrome (EPS) is the condition commonly referred to as drug induced movement disorders, due to the side effects of drugs which the patients experience from dopamine receptor antagonists. The symptoms of EPS are debilitating, which interfere with the social functioning and communication, motor tasks and activities of daily living. This ultimately is associated with poor quality of life which may result in multiple hospital visits. This case is of a 28 years old female patient who was the known case of EPS and epilepsy and was on medications of antipsychotic drug Olanzapine, dopamine receptor agonist levodopa (100mg) plus carbidopa (25mg) and anti-epileptic drug levetiracetam who presented with an abscess in left loin region for 5 days which was insidious in onset and then gradually increased in size. It was associated with pain. This case study discusses how the patient with EPS with decreased swallowing reflexes, poor nutritional status and condition requiring surgery poses challenges to the anaesthesiologists in the peri operative period.