Presentation
CASE PRESENTATION: A 55-year-old Sri Lankan man with a recent visit to South Africa presented with an acute febrile illness, cough and worsening dyspnoea with alveolar-interstitial infiltrates on chest radiography. [ncbi.nlm.nih.gov]
We present the case of a patient with orofacial dyskinesia secondary to treatment with phenytoin monotherapy. Right-handed male aged 80 years with a personal history of hypertension and atrial fibrillation. [elsevier.es]
Entire Body System
- Epilepsy
25, 2014 ; 82 (8) Resident and Fellow Section Inuka Kishara Gooneratne, Praveen Nilendra Weeratunga, Ranjanie Gamage First published February 24, 2014, DOI: https://doi.org/10.1212/WNL.0000000000000144 A 30-year-old man with a history of generalized epilepsy [neurology.org]
METHODS: We investigated the occurrence of involuntary movements in patients followed at our adult and pediatric epilepsy clinics during the period of one year. [scielo.br]
He was being treated with acenocoumarol and had been fitted with a pacemaker; there was no family history of epilepsy or movement disorders. The patient came to the emergency department with a subacute headache resistant to conventional analgesics. [elsevier.es]
The condition can be misdiagnosed for epilepsy. Myoclonus usually occurs at rest, but can also appear when the affected body part is subjected to voluntary activity, which is referred to as action myoclonus. [encyclopedia.com]
Gastrointestinal
- Overeating
METHODS: A total of 52 patients, aged over 65 years or over, who satisfied International Classification of Diseases, Tenth Revision criteria for psychotic disorders (F20-F29) were recruited into the study. [ncbi.nlm.nih.gov]
She responded partially to this regimen over the next two months. The dose of thioridazine could not be increased because of excessive sedation and anticholinergic side effects. [pmj.bmj.com]
Cross‐over studies This area of research commonly uses cross‐over studies where one person is randomly allocated the treatment only to be crossed over to receive the comparison after a designated time. [cochranelibrary.com]
Concerns over TD stimulated extensive research and fueled efforts to develop new antipsychotics that spared the extrapyramidal motor system. [mdedge.com]
Face, Head & Neck
- Facial Grimacing
On day 4 of treatment, she experienced involuntary, rhythmic facial grimacing accompanied by periodic cervical muscular contractures. [ncbi.nlm.nih.gov]
grimacing (commonly involving lower facial muscles) Finger movement (piano playing movements) Rocking or thrusting of the pelvis (duck-like gait) Jaw swinging Repetitive chewing Rapid eye blinking Tongue thrusting Restlessness When TD is diagnosed, the [medlineplus.gov]
Typical symptoms include facial grimacing, sticking out the tongue, sucking or fish-like movements of the mouth. [rarediseases.org]
Facial grimacing. Repetitive tongue protrusion. Puckering, smacking and licking of the lips. Side-to-side motion of the jaw. Withdrawal of neuroleptic medications or other offending agent. Pharmacologic treatment. [pocketdentistry.com]
Neurologic
- Dystonia
Oromandibular dystonia (OMD) is perhaps the most common of these and includes jaw opening, jaw closing, and jaw deviation dystonia. [link.springer.com]
Dystonia Dystonia is a movement disorder that causes involuntary contractions of your muscles. These contractions result in twisting and repetitive movements. Sometimes they are painful. [icdlist.com]
NOS idiopathic G24.1 ICD-10-CM Diagnosis Code G24.1 Genetic torsion dystonia 2016 2017 2018 2019 Billable/Specific Code Applicable To Dystonia deformans progressiva Dystonia musculorum deformans Familial torsion dystonia Idiopathic familial dystonia Idiopathic [icd10data.com]
Dystonia Dystonia that occurs at rest may persist as the kinetic (clonic) form. Dystonias can be either focal or generalized. [encyclopedia.com]
- Tremor
Although asterixis, dystonia, and tremor have been described with carbamazepine (Tegretol), there is no report of orofacial dyskinesia. [ncbi.nlm.nih.gov]
Subtypes of tremors include tremors at rest, essential tremor, which is a postural tremor at either rest or activity and may be inherited, or tremor with movement (intention "kinetic" tremor). [encyclopedia.com]
Tremors are a type of dyskinesia. Nerve diseases cause many movement disorders, such as Parkinson's disease. Other causes include injuries, autoimmune diseases, infections and certain medicines. [icdlist.com]
G25.1 Drug-induced tremor G25.2 Other specified forms of tremor G25.4 Drug-induced chorea Reimbursement claims with a date of service on or after October 1, 2015 require the use of ICD-10-CM codes. [icd10data.com]
- Lip Smacking
Common symptoms include lip smacking, tongue protrusions, and puffing the cheeks 1 ; severe tardive dyskinesia may affect the larynx and diaphragm, which can be life-threatening. [mdedge.com]
[…] o Neurological syndrome caused by long-term use of drugs to treat psychiatric disorders o Presents as repetitive, involuntary, and purposeless movements o Symptoms include: o Grimacing o Tongue protrusion o Lip smacking o Puckering or Pursing of the lips [slideshare.net]
Tardive Dyskinesia Symptoms Tardive dyskinesia mainly causes random, involuntary movements of the face, tongue, lips, or jaw, resulting in: Lip smacking, puckering, or pursing Tongue thrusting or protrusion Grimacing Repetitive chewing Rapid eye blinking [everydayhealth.com]
In the past tardive dyskinesia specifically referred to the classical rhythmic oral facial movements, with lip smacking, puckering, chewing movements, and slow writhing movements of the tongue in the floor of the mouth ( " Orobuccolinguomasticatory Dyskinesia [cmdg.org]
Features of the disorder may include: Frowning Tongue sticking out Lip smacking Puckering and pursing of the lips Rapid eye blinking Rapid movements of the arms, legs, and trunk may also occur. [mentalhealthamerica.net]
- Extrapyramidal Symptoms
The low prevalence of extrapyramidal symptoms associated with atypical antipsychotics has led to their widespread use during the past decade. [journalofpsychiatryreform.com]
Persistent emergent tardive dyskinesia was defined by the scores on the dyskinesia subscale of the Extrapyramidal Symptom Rating Scale. Among the 330 patients enrolled in the study, the mean age was 82.5 years. [aafp.org]
The specific tardive symptoms varied considerably. About two-thirds had no extrapyramidal symptoms. [medpagetoday.com]
Antipsychotic-induced extrapyramidal symptoms and their management. Expert Opin Pharmacother. 2008;9:1451-1462. 19. Haddad PM, Dursun SM. Neurological complications of psychiatric drugs: clinical features and management. [uspharmacist.com]
- Choreoathetoid Movements
[…] of the tongue; there may also be choreoathetoid movements of the extremities. [medical-dictionary.thefreedictionary.com]
Choreoathetoid movements of the fingers, hands, or upper or lower extremities also are common. Patients may experience axial symptoms affecting the neck, shoulders, spine, or pelvis. [mdedge.com]
Involuntary biting, clenching, chewing, mouth opening, and lateral movements of the jaw may also occur, along with protrusion, tremor, and choreoathetoid movements (ie, rolling, wormlike movement of the tongue without displacement from the mouth). [mdmag.com]
Treatment
In most cases, they occur in older psychotic patients who are in institutions and in whom long-term treatment with antipsychotic drugs of the phenothiazine and butyrophenone groups is being carried out. [ncbi.nlm.nih.gov]
During the treatment an orofacial dyskinesia develloped. Data in the literature concerning a possible link between the manifestation of orofacial dyskinesia and treatment with antidepressants were mainly found to be case reports. [cambridge.org]
Treatment varies by disorder. Medicine can cure some disorders. Others get better when an underlying disease is treated. Often, however, there is no cure. In that case, the goal of treatment is to improve symptoms and relieve pain. [icdlist.com]
Prognosis
[…] anti-psychotic medications, and some specific gastrointestinal drugs Please find comprehensive information on Tardive Dyskinesia (TD) regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention, prognosis [dovemed.com]
This action on dopamine-related events provides a basis for a possible therapeutic action o... more The long-term prognosis of tardive dyskinesia (TD) has been insufficiently studied. [scinapse.io]
Symptoms - Tardive dyskinesia Causes - Tardive dyskinesia Prevention - Tardive dyskinesia Diagnosis - Tardive dyskinesia Prognosis - Tardive dyskinesia If diagnosed early, the condition may be reversed by stopping the drug that caused the symptoms. [checkorphan.org]
Typically, patients receive antiepileptic medications, and improvement of symptoms is usually associated with a good prognosis. If symptoms do not improve with antiepileptic medication(s), the prognosis is not favorable. [encyclopedia.com]
Prognosis The earlier the problem is noticed and treatment begun, the better chance there is that the abnormal movements will go away. Most patients have a noticeable improvement in their symptoms within a year and a half. [minddisorders.com]
Etiology
SCHIZOPHRENIE CHIMIOTHERAPIE PARKINSON MALADIE PSYCHOTROPE SYSTEME NERVEUX CENTRAL PATHOLOGIE MALADIE MENTALE HOMME LEVODOPA PHENOTHIAZINE DERIVE ETUDE GENERALE PHARMACOLOGIE Keyword (en) ANTIPSYCHOTIC DYSKINESIA ELDERLY MULTIPLE DOSE FACE ORAL CAVITY LIP ETIOLOGY [pascal-francis.inist.fr]
This article presents an overview of the etiology, pathophysiology, phenomenology, and treatment of tardive dyskinesia. [medlink.com]
Managing, isolating and identifying contributing etiologies responsible for a significant catastrophic neurological alteration in muscular physiological activities found in TD may be a daunting challenge [5-8]. [medcraveonline.com]
Some evidence suggests that mentally retarded individuals taking neuroleptics have a higher incidence of TD. 9 Pathophysiology There are gaps in our understanding of the pathophysiology and etiology of TD. [mdmag.com]
[…] contain the movements with a strong, concentrated effort. 4,19 The major risk factors associated with TD are advanced age, female sex, mood disorders, organic brain dysfunction, greater total drug exposure, and early extrapyramidal symptoms (EPS). 2,4 Etiology [uspharmacist.com]
Epidemiology
Chong S.A., Sachdev P.S. eds Пє epidemiology of tardive dyskinesia. - NY Marcel Dekker. - 2004. - P. 318-320. 9. Delay J, Deniker P. 1957; Schonecker M. [bekhterevreview.com]
"Epidemiology of tardive dyskinesia before and during the era of modern antipsychotic drugs". In Vinken, P. J.; Bruyn, G. W. (eds.). Handbook of Clinical Neurology. [en.wikipedia.org]
Epidemiology of tardive dyskinesia before and during the era of modern antipsychotic drugs. Tarsy D, Lungu C, Baldessarini RJ. Handb Clin Neurol. 2011;100:601-16. [journalofpsychiatryreform.com]
No adequate epidemiologic data exist regarding whether any particular psychiatric diagnosis constitutes a risk factor for the development of tardive reactions to medications; however, the duration of exposure to antipsychotics that is required to cause [pocketdentistry.com]
Pathophysiology
The syndrome parallels several of the features of clinical tardive dyskinesia, whose pathophysiology thus may not involve changes in the characteristics of striatal dopamine receptors. [ncbi.nlm.nih.gov]
This article presents an overview of the etiology, pathophysiology, phenomenology, and treatment of tardive dyskinesia. [medlink.com]
This type of dyskinesia may occur with no underlying striatal lesion and resolve when phenytoin is discontinued; its pathophysiological mechanism is unknown. References [1] H.A. Peters, P.I. Eichmann, J.M. Price, F.A. Kozelka, H.H. [elsevier.es]
Pathophysiology of Tardive Stereotypies The pathophysiology of tardive stereotypy is not understood but striatal Dopamine (D2) receptor super-sensitivity has been the traditional explanation. [cmdg.org]
Some evidence suggests that mentally retarded individuals taking neuroleptics have a higher incidence of TD. 9 Pathophysiology There are gaps in our understanding of the pathophysiology and etiology of TD. [mdmag.com]
Prevention
[…] dose anti-psychotic medications, and some specific gastrointestinal drugs Please find comprehensive information on Tardive Dyskinesia (TD) regarding definition, distribution, risk factors, causes, signs & symptoms, diagnosis, complications, treatment, prevention [dovemed.com]
Prevention Because there is no “gold standard” treatment for TD, it is important to minimize the risk of TD by taking preventive measures and detecting incipient signs of the disorder. [mdedge.com]
The authors concluded that melatonin could be screened as a potential drug candidate for the prevention or treatment of neuroleptic-induced orofacial dyskinesia. 2 In 2003, L. [globalrph.com]
[ edit ] Prevention of tardive dyskinesia is achieved by using the lowest effective dose of a neuroleptic for the shortest time. [en.wikipedia.org]