Adeel Ur Rehman on Instagram: "Same Neck Posture… Completely Different Cause! Two patients. Severe retrocollis. Similar posture. But the underlying causes are completely different. Top clip: Drug-induced acute dystonia caused by metoclopramide. Sudden onset, reversible, due to dopamine D2 blockade in the basal ganglia. Treatable with anticholinergics. Bottom clip: Chronic cervical dystonia. Persistent, patterned neck extension caused by basal ganglia circuit dysfunction. Often managed long-term

Classify Rx on Instagram: "📍 Blood-Brain Barrier Penetration Domperidone = minimal BBB crossing → lower CNS side effects (less EPS, sedation, drowsiness). Metoclopramide = readily crosses BBB → higher risk of extrapyramidal symptoms (dystonia, akathisia, tardive dyskinesia). 📍 Extrapyramidal Risk Trade-off Metoclopramide’s central D2 antagonism causes acute dystonia, parkinsonism, and irreversible tardive dyskinesia (especially elderly, prolonged use). Domperidone’s peripheral action spares pa