Acute chorea due to ondansetron in an obstetric patient

This case describes a 34-year-old female who developed severe chorea follow ing intravenous administration of ondansetron after elective caesarean sect ion under spinal anaesthesia. A course of benztropine led to a decrease in severity of the reaction which resolved on the fifth postoperative day. Ond ansetron is believed to cause extrapyramidal reactions through actions on 5 HT(3) receptors in the basal ganglia. Whereas isolated case reports of extr apyramidal reactions to ondansetron do exist, they have typically been asso ciated with higher doses and have resolved within hours. We report the leng thiest extrapyramidal reaction to ondansetron yet described. (C) 2001 Harco urt Publishers Ltd.