Tardive Dyskinesia

Tardive Dyskinesia - Eye Symptoms

The symptoms of tardive dyskinesia were first noted in 1957, which was after U.S. psychiatrists had been using antipsychotic or neuroleptic medications for about three years. Because these symptoms usually manifested as facial tics such as involuntary movement of the lips, tongue and jaw, it was originally called bucco-linguo-masticatory syndrome, or "cheek-tongue-chewing."

By 1964, it had become clear that these symptoms were the side effect of neuroleptic medications. Moreover, these symptoms were not always confined to the face, as the muscles of the throat involved in swallowing and breathing could be affected as well. Because antipsychotic medications operate by blocking the neurotransmitters that send signals from the brain to muscle cells, virtually any voluntary muscle can be affected.

Tardive Dyskinesia and the Eyes

The effects of tardive dyskinesia on the fine musculature that control the eyes thus contributes to the difficulties that such patients experience in social situations. For example, raising the eyebrows suddenly and repetitively can give an impression of impatience to those around the patient when in fact, he or she has no control over such movements.

Such eye movements may be sudden, jerky, or smooth. Normally, smooth pursuit tracking with the eyes is extremely difficult in the absence of an actual moving object on which to focus. In the 1990s, some studies were performed to determine the connection between smooth pursuit eye movements and tardive dyskinesia; however, the study failed to establish whether the connection was with the disorder, or the mental illness for which the patients had been treated.

Rapid eye blinking is one manifestation of tardive dyskinesia. Because this is a relatively small and subtle movement, it may not necessarily be noted by those surrounding the patient. In some cases, this blinking movement — technically known as blepharospasms — can be severe enough to make the patient legally blind.

Another eye movement is called oculogic crisis. This occurs when the eyes roll about in random directions. This is a more obvious symptom than eye blinking and can cause severe disorientation. Involuntary eye movements and other such small, barely noticeable motions may be most prevalent in the earliest stages of tardive dyskinesia.

Sources

  1. American Psychiatric Association. Tardive Dyskinesia: A Task Force Report. (APA, 1992).
  2. Anderson, Elizabeth P. and Edward B. Freeman. "Recognition of Movement Disorders: Extrapyramidal Side Effects and Tardive Dyskinesias - Would You Recognize Them if You See Them?" Practical Gastroenterology, vol 28 no 4 (2004).
  3. Angelard, B et. al. "Abnormal Movements of the Larynx. Diagnostic Approach and Therapeutic Perspectives." Annales d'Oto-laryngologie et de Chirgurie Cervico Faciale, vol. 111 no. 3 (1993).
  4. "Habits and Disorders." http://www.tonguechewing.com/Habitdisorders.html
  5. Ross, David E. et. al. "The Relationship Between Smooth Eye Pursuit and Tardive Dyskinesia in Schizophrenia." Schizophrenia Research, vol 31 no. 2 (May 1998).