Deleterious Cognitive and Motoric Effects of Haloperidol in an Adolescent With Cerebral Palsy: A Case Report

Mortimer, Diane; Gelfius, Carl D.; Potts, Michelle

doi:10.1016/j.pmrj.2013.07.002

PM&R

2013

DOI: 10.1016/j.pmrj.2013.07.002

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Deleterious Cognitive and Motoric Effects of Haloperidol in an Adolescent With Cerebral Palsy: A Case Report

Diane Mortimer

Carl D. Gelfius

Michelle Potts

Abstract: This case report describes a 15-year-old male patient with spastic diplegic cerebral palsy, Gross Motor Function Classification System Level III, who developed severe new cognitive and motoric impairments after the administration of haloperidol. He received this dopamine antagonist and typical antipsychotic medication for an acute postoperative episode of agitation. He improved when he received the dopamine agonists amantadine and carbidopa/levodopa. This case suggests that dopamine blockade may be deleterious… Show more

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Haloperidol

2014

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S Haloperidol Severe cognitive and motoric impairments: case reportA 15-year-old boy developed severe cognitive and motoric impairments after treatment with haloperidol.The boy, with a history of spastic diplegic cerebral palsy, underwent small bowel resection due to small bowel obstruction and required paediatric intensive care management. On hospital day 7, he was successfully extubated and after few hours, be became acutely agitated. He was hallucinating and pulling his lines and tubes. As he was at risk for self-harm, he was administered 2 separate doses of IV haloperidol at 5mg within a half hour interval. He became unresponsive minutes after he received the second dose. He was non-verbal, non-interactive, had no spontaneous movement and remained in this state far beyond the expected time frame for haloperidol-associated sedation. On hospital day 14, his severe cognitive and motoric alterations persisted. He was at a dependent level for all activities as per the Pediatric Functional Independence Measures (Wee-FIM). He was not following directions and did not provide any verbal responses. He did not move his upper limbs and demonstrated only trace non-purposeful movement of his lower limbs. His tone was at baseline of normal except for increased resistance during bilateral ankle range of motion.On hospital day 19, the boy started receiving amantadine. One hour after receiving the first dose, he began moving his upper limbs spontaneously. After the second and third doses, he opened his eyes and interacted. His alertness and overall function continued to improve during the next 3 days. He vocalized and began moving his upper limbs in an effort to feed himself. He was able to swallow safely. In the following week, he continued to show improvement in cognitive and motoric function. On hospital day 31, he additionally started receiving levodopa/carbidopa. On hospital day 54, he was discharged with functional status near his pre-hospitalisation level. Eight weeks after discharge, his Wee-FIM scores for most items, other than bowel and bladder function, returned to his pre-hospitalisation levels.Author comment: "In this case presentation, a 15-year-old male ... experienced severe functional decline after the administration of haloperidol." "The case suggests that dopamine blockade may result in deleterious motoric and cognitive effects and a negative impact on function in some individuals with [cerebral palsy]." Mortimer D, et al. Deleterious cognitive and motoric effects of haloperidol in an adolescent with cerebral palsy: a case report. P M and R

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Haloperidol

2014

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Safety and tolerability of antipsychotic agents in neurodevelopmental disorders: a systematic review

Iasevoli

Barone

Buonaguro

et al. 2020

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Deleterious Cognitive and Motoric Effects of Haloperidol in an Adolescent With Cerebral Palsy: A Case Report

Cited by 2 publications

References 22 publications

Haloperidol

Haloperidol

Safety and tolerability of antipsychotic agents in neurodevelopmental disorders: a systematic review

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