Case Report Phencyclidine Induced Oculogyric Crisis Responding Well to Conventional Treatment Hassan Tahir and Vistasp Daruwalla Department of Internal Medicine, Temple University/Conemaugh Memorial Hospital, 1086 Franklin Street, Johnstown, PA 15905, USA Correspondence should be addressed to Hassan Tahir; htahir@conemaugh.org Received 3 March 2015; Revised 10 May 2015; Accepted 18 May 2015 Academic Editor: Oludayo A. Sowande Copyright © 2015 H. Tahir and V. Daruwalla. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Oculogyric crisis is a form of acute dystonic reaction characterized by involuntary upward deviation of eye ball. Its causes are broad with antipsychotics and antiemetics as the most common causes. Case Presentation. A 25-year-old man with the past medical history of marijuana use presented to ED with involuntary upward deviation of eye 1 day afer using phencyclidine (PCP) for the frst time. He did not have any other symptoms and was hemodynamically stable. All laboratory investigations were normal except urine drug screen which was positive for PCP. Patient was treated with IV diphenhydramine which improved his symptoms. Conclusion. Illicit drug abuse is a growing problem in our society with increasingly more patients presenting to ED with its complications. Te diferential diagnosis of acute dystonic reactions should be extended to include illicit drugs as the potential cause of reversible acute dystonias especially in high risk patients. 1. Introduction Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions causing abnormal, ofen repetitive, movements, postures, or both. Dystonic move- ments are typically patterned, twisting, and may be tremu- lous. Dystonia is ofen initiated or worsened by voluntary action and associated with overfow muscle activation [1]. Drug induced acute dystonia (DID) is one of the commonest forms of secondary dystonia, along with tardive dystonia. Tis complication occurs in wide frequency range, depending on the specifc drugs prescribed, indications, and studied populations [2]. Clinical presentation commonly includes craniocervical distribution with blepharospasm, buccolin- gual, mandibular, face and neck dystonia, and oculogyric crisis with contracture of the extraocular muscles leading to conjugate eyes deviation, usually with a predominance of the superior rectus muscle and consequent upward eye deviation [3]. Drug abuse is a rising problem in our society with increas- ing number of drug abusers being brought to the emergency department because of its complications. Hallucinogens are a class of illicit drugs that cause profound distortion in person’s sense of reality. Phencyclidine (PCP), also known as angel dust, is the most dangerous of all hallucinogens due to its efect on behaviour. Unfortunately, there has been a recent increase in the number of emergency visits involving PCP [4]. Rare manifestations and complications of PCP are increasingly seen due to the rising burden of its use [5]. We report a case of 25-year-old man who developed acute oculogyric crisis afer using PCP for the frst time. 2. Case Presentation A 25-year-old man presented to emergency department with involuntary sustained upward deviation of eyes for one day. According to the patient, he had been using marijuana almost once in a week for the last 5 years but this time he wanted to try a diferent drug. One day ago, he smoked angel dust with tobacco and also snorted it a little. Tis was the frst time he was using PCP and as per the patient he used very small quantity. Afer that he felt dizzy and slept whole night. When patient woke up in the morning, he had both of his eyes involuntary deviated in upward direction. His girlfriend immediately brought him to ED for further evaluation. Te patient denied any fever, headache, light headedness, slurred speech, weakness, diplopia, and auditory or visual hallucinations. Patient did not have any Hindawi Publishing Corporation Case Reports in Emergency Medicine Volume 2015, Article ID 506301, 3 pages http://dx.doi.org/10.1155/2015/506301