MRCP revision battle 30.2: Oculogyric Crisis

The key features of an oculogyric crisis are restlessness and upward deviation of the eyes (although this only occurs in severe cases).


Oculogyric crises may be precipitated by a range of drugs including:

• neuroleptics
• metoclopramide/domperidone
• nifedipine
• TCA
• carbamazepine

Several clinical conditions can also cause oculogyric crises, for example:

• parkinsons disease
• post encephalitis
• bilateral thalmic infarction
• MS

Treatment is with procyclidine, an anticholinergic.


On to the next battle...