Dystonic reactions to phenothiazine derivatives.

Phenothiazine derivatives are widely used and their toxic effects in adults are well recognized. They include dizziness, mild skin reactions, jaundice, motor restlessness, and occasionally neuromuscular reactions. Dystonia and symptoms resembling parkinsonism usually occur only at high dosages. These are well-recognized complications in mental hospitals when drugs are being used to treat psychotic conditions, but have only been infrequently described in children. Recently we have encountered 5 cases in which alarming side-reactions have occurred, where the diagnosis of tetanus, encephalitis, or cerebral metastases was considered.