Bacground: Acute Drug-Induced Dystonia is a common type of extrapyramidal movement disorder. This condition is characterized by involuntary and sustained contractions of skeletal muscles, which can lead to abnormal postures such as torticollis, oculogyric crisis, facial spasm, laryngospasm, and opisthotonus.

Case Presentation: A 6-month-old female infant was brought to the pediatric emergency department by her parents due to the sudden onset of neck deviation to the right (torticollis) since the morning of admission. The parents stated that the child woke up with her head in an abnormal position and was unable to return it to the central position. The medication history revealed that the mother had received a single dose of intravenous metoclopramide the night before at a medical center due to nausea and vomiting. The infant herself had not received any other medications. Neurological examination showed no focal signs, meningeal stiffness, signs of increased intracranial pressure, or other involuntary movements. The patient received a single dose of biperiden 0.04 mg/kg intramuscularly. Reports from parents and the treatment team indicated that within minutes, the neck deviation was completely corrected, and the infant regained the ability to move their head freely. No recurrence of symptoms was reported during 6 hours of emergency monitoring.

Conclusion: This report shows that: 1-Acute drug-induced dystonia should be one of the primary diagnoses in sudden torticollis in infants. 2- Taking a detailed drug history is very important.3- Rapid diagnosis and initiation of anticholinergic treatment lead to complete recovery and prevent unnecessary invasive procedures.