This book describes Tardive Dystonia, Diagnosis and Treatment and Related Diseases
Tardive dystonias are neurological syndromes that resulted from exposure to certain medicines, mainly a class of medicines called neuroleptics which are given to treat psychiatric disorders, some gastric disorders, and certain movement disorders
It is a movement disorder featured by involuntary muscle contractions caused primarily by taking dopamine receptor blockers like antipsychotic medications.
Tardive dystonia is a form of tardive dyskinesia that involves abnormal movements.
The movements most often involve the lower face.
TD causes stiff, jerky movements of the face and body that the patient cannot control.
The patient may stick out the tongue, blink the eyes or wave the arms without intending to do so.
Causes
TD is a serious side effect that happens when the patient take medicines called neuroleptics.
These drugs are also called antipsychotics or major tranquilizers used to treat mental disorders.
TD often happens when the patient take the drug for many months or years
Drugs that most often cause this disorder are older anti-psychotics such as:
1. Chlorpromazine
2. Fluphenazine
3. Haloperidol
4. Perphenazine
5. Prochlorperazine
6. Thioridazine
7. Trifluoperazine

Other drugs that can cause TD are:
1. Metoclopramide (treats stomach problem called gastroparesis)
2. Antidepressant drugs such as amitriptyline, fluoxetine, phenelzine, sertraline, trazodone
3. Anti-parkinson drugs such as levodopa
4. Anti-seizure drugs such as phenobarbital and phenytoin
Newer anti-psychotics appear less likely to cause TD, but they are not entirely without risk.
Drugs belonging to this class of neuroleptics are:
1. Acetohenazine (Tindal),
2. Amoxapine (Asendin),
Tardive dystonia and tardive dyskinesia are not the same.
Generally, people with tardive dyskinesia have abnormal movements that are rapid, brief, jerky, discrete, and stereotyped.
People with tardive dystonia have abnormal movements that are slower, painful, and twisting, and force parts of the body into abnormal postures.
Tardive dystonia can take many forms:
blepharospasm of eyelid
spasmodic torticollis of neck
bruxism of teeth
dysphonia of speech
ballismus of limb
Symptoms
Tardive dystonia produces stiff, involuntary muscle movements that the patient cannot control.
Often, these are in the face mainly the lips, jaw, or tongue.
If the patients have it, the patient might:
1. Stick out the tongue without trying
2. Blink the eyes fast
3. Chew
4. Smack or pucker the lips
5. Puff out the cheeks
Diagnosis:
The doctor can give the patient a physical exam test called the Abnormal Involuntary Movement Scale
To exclude other disorders, the patient may get:
1. Blood tests
2. CT or MRI scan of brain
Treatment
When TD is diagnosed, the doctor will either have the patient stop the medicine or change to another one.
The treatment of tardive dystonias will normally require a slow withdrawal from the causative medicine.
If neuroleptics are an essential treatment of a patient's health, a class of newer, "atypical" neuroleptics (such as clozapine, olanzapine, and quetiapine) may be an alternative.
Anticholinergics (such as trihexyphenidyl and benztropine) and muscle relaxants that are prescribed to treat other forms of dystonia may also be helpful.
Baclofen and clonazepam are also given to treat tardive dystonia.
Botulinum toxin injections to a particular muscle group are an extra...