Rhythmic stereotyped repetitive involuntary movements

Introduction The clinical manifestations of tardive dyskinesia are rhythmic stereotyped repetitive involuntary movements. Tardive dyskinesia (TD), also known as delayed onset dyskinesia, persistent dyskinesia, induced by antipsychotic drugs, is a persistent stereotyped repetitive involuntary movement. Crane (1968) first proposed that it is the most severe and thorny extrapyramidal reaction caused by antipsychotic treatment, and the incidence is quite high. The most common are caused by phenothiazines and butyrophenones. The incidence of oral antipsychotic drugs is 20% to 40%, and the incidence of long-acting antipsychotic drugs is about 50%.

Cause

More common in long-term (more than 1 year) high doses of anti-psychotic drugs that block or bind to dopaminergic receptors, especially phenothiazines such as chlorpromazine, perphenazine, butyrylbenzenes such as haloperidol Etc., can cause TD. Certain dopamine drugs such as levodopa, Madopar, Parkinin, and tranquilizers can also cause TD-involuntary movements. Occasionally, patients who take antidepressants, anti-PD drugs, anti-epileptic drugs and antihistamines for a long time are prone to reduction or withdrawal.

Relevant factors include:

1 Age, gender factors: Older people are prone to occur, not easy to recover, more women than men.

2 patients with brain lesions are prone to use antipsychotic drugs, negative symptoms of schizophrenia patients with early onset of TD, a high incidence.

3 drug factors: drug dose and duration of treatment are related to TD, more common in patients with Parkinson syndrome in the early stage of treatment.

an examination

Related inspection

Positron emission computed tomography (PET) cranial nerve examination

Diagnose based on relevant symptoms.

Differential diagnosis

The disease must be distinguished from the following diseases:

1. Drug-induced Parkinson syndrome: Because DR is occupied or blocked by antipsychotic drugs, endogenous DA can not bind to DR, although there is also a history of antipsychotics, but involuntary exercise shows muscle rigidity, exercise reduction and movement Eye crisis and so on.

2. Huntington's disease: According to the genetic history, chorea and dementia and other three main signs, it is not difficult to identify with TD, HD patients also commonly used antipsychotic drugs, if there is meditation can not be repeated or repeated stereotypes involuntary movement prompted TD.

3. Meige syndrome: is a common oral dyskinesia, complete type of mouth, mandibular dystonia, there are eyelids; non-complete type only mouth, tongue, pharynx and mandibular dystonia, or only the primary Sexual eyelids; no history of antipsychotics.

4. Twisting : Involuntary movement with rapid performance, stereotyped repetition, no history of taking antipsychotics.

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