Disease Information for Tardive dyskinesia syndrome

Clinical Manifestations
Signs & Symptoms
Facial grimacing
Facial tic
Bucco-lingual-masticatory movements
Chewing motions
Puffing of cheeks
Tongue movements/involuntary
Worm-like tremor/tongue spasms
Choreoathetoid movement
Cogwheel resistance/passive stretch
Dystonia, acquired
Extrapyramidal signs
Hyperkinetic Movement Disorder
Lip smacking
Movement disorder/clears in sleep status
Movement or gait disorder/signs
Odd body posturing
Protrusion of tongue/involuntary
Rhythmic jaw movements
Ruminating Jaw Movements
Shuffling 'magnetic' gait
Spasms in Neck
Tremor in Elderly
Disturbed gag reflexes
Speech disturbance/motor
Increased blinking frequency
Disease Progression
Course/Chronic disorder
Course/Chronic only
Demographics & Risk Factors
Established Disease Population
Patient/Phenothiazine treated
Patient/Long-term neuroleptics/thorazines
Patient/Diabetes mellitus
Population Group
Aged Adult
Status/Institutionalized patient
Event, Activity, Behavioral & Seasonal Factors
Lifestyle/Tobacco/cigarette smoking
Sex & Age Groups
Population/Adult Aged Only
Population/Elderly Aged
Population/Seventies Adult
Diagnostic Test Results
Xray/Skull pineal calcifications
Associated Diseases & Rule outs
Associated Disease & Complications
Drug induced Movement disorder
Drug induced tremor/movement disorder
Extrapyramidal disease/manifestation
Parkinsonism, secondary
Tardive dyskinesia syndrome
Torticollis, acquired
Secondary Dystonia
Disease Synergy - Causes
Synergy/General stress
Synergy/Psychologic stress
Disease Mechanism & Classification
CLASS/Basal ganglia lesion/involvement/disorders (ex)
CLASS/Neurologic (category)
Pathophysiology/Hypersensitive dopamine receptors/CNS
Pathophysiology/Striatum CNS involvement
PROCESS/Complicating disorder (ex)
PROCESS/Movement disorder (ex)
PROCESS/Poisoned organ/system (category)
PROCESS/Vegetative-Autonomic/Endocrine (category)
PROCESS/Hyperkinetic Movement disorders
Drug induced tardive dyskines, Drug induced tardive dyskinesia, Dyskinesia tardive, TARDIVE DYSKINESIA, Tardive dyskinesia (disorder), Tardive dyskinesia RETIRED, TD Tardive dyskinesia, Synonym/Dyskinesic syndrome, Synonym/Linguofacial dyskinesia, Synonym/Oral-facial dyskinesia, Synonym/Tardive dystonia/variant, Synonym/Tardive oral dyskinesia, Synonym/TD
Drug Therapy - Indication
RX/Atenolol (Tenormin)
RX/Baclofen (Lioresal)
RX/Biperiden (Akeniton)
Rx/Buspirone (Buspar)
RX/Carbamazepine (Tegretol)
RX/Clonidine (Catapres)
RX/Lithium (Lithobid)
RX/Olanzepine (Zyprexa)
RX/Propranolol (Inderal)
RX/Trihexyphenidyl (Artane)
RX/Vitamin E
Surgical Procedures or Treatments
TX/Botox local injections specific sites

Tardive dystonia is a persistent form of dystonia caused by exposure to dopamine receptor-blocking drugs such as major tranquilizers (eg, chlorpromazine, thioridazine, fluphenazine, thiothixene, haloperidol, loxapine, amoxapine) and certain antiemetics (eg, prochlorperazine, metoclopramide) ; Levodopa can also cause intermittent dystonia (and focal dystonia may be the initial symptom of Parkinson"s disease); In all drug-induced dystonias, the offending drug should be withdrawn or the dosage reduced if possible; In contrast to focal, segmental, or generalized dystonia, hemidystonia is associated with an identifiable cause in most cases, including subcortical infarction, arteriovenous malformation, abscess, tumor, and other lesions, some of which can be treated surgically; Many other causes of secondary dystonia are possible, but only a few are amenable to therapy; Treatment of dystonia consists of supportive therapy (eg, relaxation techniques, prostheses), medications, botulinum toxin injections, and surgery; Anticholinergic drugs are sometimes beneficial; Trihexyphenidyl, the most frequently used anticholinergic, must be started in low doses and slowly increased to tolerance, perhaps up to 60 mg/day; Some children can tolerate such high doses, but anticholinergic side effects usually limit adult tolerance to 20 to 25 mg daily or less; In advanced cases, dopamine-depleting and dopamine receptor-blocking drugs may be added; Muscle relaxants (eg, diazepam or lorazepam), baclofen (administered either orally or as a continuous intrathecal infusion), and carbamazepine sometimes provide benefit; About 10% of patients with childhood or adolescent dystonia improve with levodopa, so levodopa should be tried in all cases of childhood and in some cases of adult-onset dystonia; In patients with refractory focal dystonia and, less often, segmental dystonia, injection of the paralysis-inducing botulinum toxin into the contracting muscles provides effective, albeit temporary, relief; Patients who are socially and occupationally disabled by dystonia despite optimal medical therapy, including botulinum toxin, can sometimes be helped surgically; Surgical procedures include orbicularis myectomy for blepharospasm, cervical rhizotomy for neck dystonia, and thalamotomy, pallidotomy, or deep brain stimulation of the subthalamic nucleus or pallidum for hemidystonia or generalized (predominantly distal) dystonia; Such procedures are effective in most patients but are associated with both potentially serious complications and high rates of symptom recurrence, thus making them a last resort

----------[Access Medicine McGraw-Hill Current DXRX Medicine Website 2006]--------------


External Links Related to Tardive dyskinesia syndrome
PubMed (National Library of Medicine)
NGC (National Guideline Clearinghouse)
Medscape (eMedicine)
Harrison's Online (accessmedicine)
NEJM (The New England Journal of Medicine)