Body shaking sign

Introduction The body trunk movement is uncoordinated, and it is in a strange posture, such as shrug and shoulder retraction, horn arch reversal, twisting sputum, diaphragmatic movement and snoring to produce snoring and breathing difficulties; sometimes manifested as whole body swaying, torso flexing and stretching repeatedly, before and after Twisting or leaning forward, known as bodyrocking.

Cause

More common in long-term (more than 1 year) large doses of anti-psychotic receptors, or combined with antipsychotics, especially phenothiazines such as chlorpromazine, butyrylbenzenes such as haloperidol Some TD-induced dopamine drugs such as levodopa, Madopar, and Parkinine can also cause TD-like health search involuntary movements. Occasionally, patients with long-term antidepressants, anti-PD drugs, anti-epileptic drugs and antihistamines Reduction or withdrawal is easy to occur. Relevant factors include: 1 age and gender factors: old people are prone to healthy search, not easy to restore more women than men; 2 brain disease patients are prone to antipsychotic drugs, negative symptoms of schizophrenia patients with TD Early onset rate is high; 3 drug factor health search: drug dose and duration of treatment are more related to TD occurrence in patients with Parkinson syndrome in the early stage of treatment.

Pathogenesis: The pathogenesis of tardive dyskinesia is unclear. Central dopaminergic neuron damage is a doctrine. There have also been reports on the hypothesis that the function of GABAergic system is reduced, and the neurotoxic antipsychotic drug produced by free radicals has a direct effect on the nervous system.

It is generally believed that long-term use of high-dose antipsychotic drugs such as phenothiazines and butyrylbenzenes can block synapses for a long time, and post-dopamine receptor (DR) health search increases synaptic dopamine (DA) synthesis and release feedback. Post-synaptic DR is more sensitive to DA response and produces DR hypersensitivity. DA in a physiological dose of denervationhypersensitivity can cause dyskinesia and often induce or cause symptoms after using levodopa or discontinuing antipsychotics. Aggravation also supports the refinement of TD symptoms, haloperidol can temporarily cover up the symptoms, DA synergist can make the symptoms worse.

an examination

Related inspection

Brain CT examination EEG examination

First, there must be a history of taking antipsychotic drugs. The dyskinesia occurs in the patient taking the drug or within 3 months after stopping the drug. The dyskinesia is characterized by rhythmic, abnormal, stereotypical and involuntary movements. The physiological dose of DA in the denervation state can cause dyskinesia and often induce or aggravate the symptoms after levodopa or discontinuation of antipsychotics. It also supports risperidine to alleviate TD symptoms. Haloperidol can temporarily mask symptoms. , DA synergist can make symptoms worse.

Differential diagnosis

Need to be identified with the following symptoms:

Torsion spasm: also known as idiopathic torsion spasm (ITS), torsion dystonia, primary dystonia, clinical dystonia and limbs The trunk and the body are characterized by intense and involuntary torsion. It is divided into primary and secondary, and primary is more common.

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