Background: A 36-year-old Thai female who underwent a thymectomy under general anesthesia developed acute abnormal movements in the craniofacial region immediately after awakening with preserved consciousness. Phenomenology: Intermittent abnormal movements included oculogyric crisis; tongue protrusion; blepharospasm; and oro-mandibular dystonia consisting of risus sardonicus, jaw opening, and right torticollis. Educational value: An acute dystonic reaction can be a complication of either single or combined general anesthetic agents.
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Jitprapaikulsan et al. (2017) studied this question.