Tardive Dyskinesia

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Part of the Current Clinical Neurology book series (CCNEU)


Tardive dyskinesia (TD) refers to a movement disorder characterized by persistent involuntary movements which appears after chronic exposure to dopamine receptor blocking agents (DRBAs) such as antipsychotic drugs or metoclopramide. As defined by the American Psychiatric Task Force, the diagnosis of TD requires 3 months of exposure to a DRBA, although cases occasionally appear earlier. Classical TD is the most common persistent adverse reaction to prolonged exposure to neuroleptic medications and was the first tardive syndrome to be identified.

Typical orofacial movements include tongue protrusion, chewing (rumination), and “bridling” (retraction of the corners of the mouth). Dyskinesia of the tongue is characterized by protrusion or lateral tongue movements within the mouth which may produce a bulge in the cheek, referred to as the “bonbon sign.”


Movement Disorder Prolonged Exposure Chronic Exposure Antipsychotic Drug Tardive Dyskinesia 
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Supplementary material

The patient exhibits characteristic features of TD of the tongue with repetitive protrusion outside the mouth, retraction within the mouth, and lateral tongue movements which the patient is unable to suppress. She walks slowly with reduced arm swing bilaterally.

Tardive Dyskinesia.mp4 (MP4 20,680KB)


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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