Tardive Dyskinesia (TD)
Understanding TD
Tardive dyskinesia (TD) is a movement disorder that is characterized by uncontrollable, abnormal, and repetitive movements of the face and/or other body parts. TD is caused by long-term use of a class of medication known as neuroleptics, which are often prescribed for management of certain mental, neurological, or gastrointestinal disorders. In individuals with TD, these medications are thought to cause irregular dopamine signaling in a region of the brain that controls movement.
Symptoms of TD
Although most cases occur after taking TD-causing neuroleptic medications for several years, some cases may occur with shorter use.
Symptoms include uncontrollable movements of the face and body. They can often be persistent and potentially disabling. The uncontrollable movements may be disruptive due to the symptoms themselves and the impact they have on emotional and social well-being. Symptoms include:
- Facial grimacing (commonly involving lower facial muscles)
- Finger movement (piano playing movements)
- Rocking or thrusting of the pelvis (duck-like walk)
- Jaw swinging
- Repetitive chewing
- Rapid eye blinking
- Tongue thrusting
- Restlessness
Diagnosing TD
Diagnosis of tardive dyskinesia (TD) is done by physical examination and history of using medication known to be associated with TD. There are no blood, laboratory, or imaging tests done to diagnose TD.
Treatment of TD
While the symptoms of tardive dyskinesia (TD) can often be persistent and potentially disabling after the discontinuation of the suspected TD-causing medication, TD can be managed. The suspected medication should be slowly discontinued or switched to another one. If TD is mild or moderate, various medications may be tried. Medication (taken orally) used to treat TD include tetrabenazine (Xenazine®), verbenalin (Ingrezza®) and deutetrabenazine (Austedo®). If TD is very severe, a procedure called deep brain stimulation (DBS) may be tried. DBS uses a device called a neurostimulator to deliver electrical signals to the areas of the brain that control movement.
References:
- Tardive Dyskinesia | National Institute of Neurological Disorders and Stroke
- Tardive Dyskinesia | Medline Plus
- Tardive Dyskinesia | National Organization for Rare Disorders
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