Intravenous Hyoscine Butylbromide “Scopolamine” for the Treatment of Extrapyramidal Symptoms: A Case Report

Abstract

Aim: Extrapyramidal symptoms (EPS) represent motor disturbances frequently induced by medications that impact the dopamine pathways. Although not traditionally employed for addressing EPS, there is potential in using hyoscine butylbromide, an anticholinergic antispasmodic, owing to its mechanism of action that influences cholinergic receptors. Presentation of Case: We present a 34-year-old female patient, post-haemorrhoidectomy under spinal anaesthesia, who developed post-lumbar puncture headache with nausea and vomiting. A single dose of metoclopramide (10 mg) led to rapid onset of EPS—tremor, restlessness, and akathisia. Intravenous hyoscine butylbromide (20 mg) resulted in prompt alleviation of EPS. Discussion and Conclusion: This case highlights hyoscine butylbromide's potential in managing medication-induced EPS, even in unconventional cases. Rapid symptom resolution and a 7-day follow-up without side effects underscore its short-term efficacy and safety. While broader application and mechanisms necessitate further research, hyoscine butylbromide could be a valuable option for EPS management.