Dystonic reaction associated with ondansetron administration in a patient with normal pressure hydrocephalus

J Clin Anesth. 2015 Aug;27(5):423-5. doi: 10.1016/j.jclinane.2015.03.037. Epub 2015 Apr 29.


A 77-year-old female with normal pressure hydrocephalus underwent urgent revision of the abdominal component of a ventriculoperitoneal shunt. Upon emergence from an uneventful general anesthetic, the patient exhibited cogwheel rigidity with decerebrate posturing and a markedly irregular respiratory rate. This prohibited extubation and prompted an unplanned intensive care unit admission. Ondansetron was the only medication administered that had previously been associated with dystonic reactions. In a previous procedure, the patient had been given ondansetron without a similar reaction. This presentation may have been provoked by existing pathology such as her underlying normal pressure hydrocephalus and small increases in intracranial pressure.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Anesthesia, General / methods
  • Dystonia / chemically induced*
  • Female
  • Humans
  • Hydrocephalus, Normal Pressure / complications
  • Hydrocephalus, Normal Pressure / surgery*
  • Intracranial Pressure / physiology
  • Ondansetron / adverse effects*
  • Reoperation
  • Ventriculoperitoneal Shunt / methods*


  • Ondansetron