Tardive dystonia (TD) refers to involuntary dystonic movements and postures which, like tardive dyskinesia (see Chap. 77), are due to the chronic use of dopamine receptor blocking agents (DRBAs) such as antipsychotic drugs and metoclopramide. Young adults appear to be particularly susceptible to this disorder. Although choreiform movements may occur, the principal feature is dystonia which must be present for more than a month and occur either during ongoing treatment with a DRBA or within 3 months of its discontinuation. Dystonic movements in TD differ from classical tardive dyskinesia in several ways: (1) They commonly involve axial muscles of the neck and trunk; (2) they tend to be more action specific, occurring intermittently with certain actions or postures and without exhibiting the more regular periodicity of classical tardive dyskinesia; (3) dystonic movements can sometimes be partially suppressed by simple sensory tricks; (4) unlike tardive dyskinesia, TD occurs more often among men than women.
KeywordsBotulinum Toxin Antipsychotic Drug Tardive Dyskinesia Trunk Muscle Botulinum Toxin Injection
Tardive Dystonia.mp4 (MP4 13,693KB)
The patient displays retrocollis and left laterocollis. Orobuccal dystonia and dyskinesia are evident together with blepharospasm. Mild truncal dystonia and scoliosis are also present. His legs are minimally affected.