Tardive Dyskinesia and/or Dystonia - Medtick

Tardive Dyskinesia and/or Dystonia

What is it?

A condition where your face and/or body make sudden, jerky or slow twisting movements which you can’t control.

  • Tardive’ means delayed or appearing late (because it usually only develops after you’ve been taking medication for at least a few months and sometimes years).
  • Dyskinesia’ means abnormal or unusual movements.

www.mind.org.uk

  • Dystonia is a movement disorder in which your muscles contract involuntarily, causing repetitive or twisting movements. The condition can affect one part of your body (focal dystonia), two or more adjacent parts (segmental dystonia) or all parts of your body (general dystonia).

Mayo Clinic


Other types:

Neuroleptic-induced tardive dyskinesia

  • Minor problems with co-ordination,  movement disorder caused by damage to the developing brain, and rhythmic movements of the tongue, jaw, trunk, and extremities.
  • Diagnosis of neuroleptic – induced tardive dyskinesias generally requires symptoms that persist for 1 month after exposure to neuroleptics for at least 3 months.
  • At least 1 month of exposure is typically required if the patient is aged 60 years or older.

Blepharospasm

  • Repetitive, forceful, sustained contraction of the orbicularis oculi (a muscle in the face that closes the eyelids), it may occur as on its own.
  • When it occurs in conjunction with dystonia of the lower face, jaw, and neck, it is referred to as Meige syndrome.

Tardive blepharospasm

  • Repetitive sustained contractions of the orbicularis oculi that have lasted for at least 1 month and that developed during or within 3 months of the discontinuance of treatment with dopamine antagonists (in the absence of other disease or familial causes).
  • Symptoms of tardive blepharospasm fluctuate. fatigue, anxiety, work, and light exacerbate tardive blepharospasm, whereas rest and sleep relieve it.

Tardive dystonia

  • Occurs during long-term treatment with dopamine antagonists:
    • Bromocriptine
    • Carbidopa-levodopa
    • Levodopa
  • It must be differentiated from acute dystonia, which occurs in the first days of neuroleptic treatment or after an increase in the dose.

Tardive dystonia

  • Fixed posturing of the face and neck [i.e. anterocollis-produces patterned, repetitive muscle contractions that result in neck flexion (movement of lowering your chin down to your chest), retrocollis- contraction in the neck causing the head to move back, torticollis), extremities, and trunk.
  • It may be either localised, involving one or more body parts, or generalised.
  • Unlike tardive dystonia, torsion dystonia is characterised by twisting and sustained contractions of muscles resulting in rapid, repetitive, distressing movements.

Torsion dystonia

  • Inversion of the foot and spasm of the proximal limb muscles, resulting in gait abnormalities.
  • Scoliosis, torticollis, and tortipelvis (slipped disc)  may occur in torsion dystonia. Patients may experience considerable impairment in performing activities of daily living.

Tardive akathisia

  • Subjective symptoms of restlessness and the urge to move.
  • It refers to the inability to sit down or remain still.
  • Person with tardive akathisia exhibit constant pacing and moving of the hands and feet.
  • They typically shift their weight from one foot to the other when standing and swing their legs when sitting.
  • It occurs as the dose of the dopamine antagonist is decreased after long-term treatment.

Tardive akathisia

  • Persons with akathisia complain of inner restlessness and the inability to remain still. Unlike other movement disorders.

Medscape


Diagnosis Tests

  • Diagnosed solely on the basis of the patient’s subjective symptoms in the absence of any objective signs.
  • The Hillside Akathisia Scale is often helpful.

Medscape


Stopping Tardive Dyskinesia causing medication

  • Discontinuing the medication which is causing the symptoms may lead to a reversal of tardive dyskinesia, but this is frequently not the case.
  • Tardive dyskinesia is often permanent.
  • The symptoms may become less pronounced once the person has been off of the medication for a time.

www.brainandspinalcord.org

Cause

Medication

Illicit drugs

  • Amphetamine
  • Methylphenidate

Secondary dystonia may result from a wide variety of neurologic diseases or inherited metabolic defects, including:

Medscape

Other rare conditions include:

Syndromes

Symptoms

  • Aching, painful muscles, muscle cramps/spasms/stiffness?
  • Joint pain and stiffness?
  • Jerky movements  (irregular movements which aren’t rhythmic or repetitive)?
  • Blinking and/or rolling of eyes?
  • Lip smacking?
  • Contraction/spasms and pain of mouth?
  • Jaw lock?
  • Grunting?
  • Twisting their neck?
  • Short of breath or breathing difficulties?
  • Twitching one’s nose and/or face ,arms/legs?
  • Bone and joint movements (movement in mouth, jaw, hips,hands, feet)?
  • Wiggling and/or twisting and/or tingling sensation to lips, tongue, fingers and feet?
  • Slowness of  movements?

Complications /Information to beware of/General tips:

This condition may show similar symptoms to:

Please talk to your healthcare professional (i.e. Medical Doctor/Pharmacist) for further advice

Detailed Information

Please copy and paste any key words from the title: Tardive Dyskinesia and/or Dystonia in the following respective 'Medtick References and/or Sources' to find out more about the disease (this also may include diagnosis tests and generic medical treatments).

  • NHS

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  • Medscape

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