Neck and Spine - Tardive Dyskinesia Symptoms

When antipsychotic drugs were first introduced in the United States by Smith Kline & French (now GlaxoSmithKline) in 1954, the psychiatric community hailed the medications as one of the greatest advances in the history of medicine. By 1957, the symptoms associated with tardive dyskinesia were beginning to appear among patients who had been treated with these neuroleptic drugs.

Although the symptoms of tardive dyskinesia most commonly consist of facial tics, vacuous chewing motions, rapid eye blinking and movements of the lips and tongue, the symptoms can affect any part of the body. In some cases, they can affect muscles involved in respiration and swallowing, causing a potentially life-threatening situation.

In any event, these symptoms can appear as soon as three months after taking antipsychotic or neuroleptic medications, or may not appear for several years. Symptoms can be permanent and may increase in severity as a result of withdrawal once the patient is taken off of such medication.

Antipsychotic or neuroleptic medications target dopamine receptors, which transmit instructions from the brain to the body's cells. Dopamine controls a wide range of functions that range from simple motor function to emotive and cognitive functions. It is the inhibition of dopamine involved in voluntary muscle movement that ultimately causes the uncontrollable movements characteristic of tardive dyskinesia.

Affecting Posture

Although less common than facial tics and movements, the disorder often affects posture and gait as well. "Wry neck," known technically as torticollis, is a collection of symptoms that involve the head, neck and upper spine. It is a condition that causes a patient's head to tilt in one direction with the chin elevated and turned toward the other.

These symptoms may have any number of causes, including trauma to the upper vertebrae, malignant tumors at the base of the skull or even certain bacterial infections. The condition may also be congenital. However, it has been established that torticollis can also be due to the side effects of neuroleptic medications, and therefore a symptom of tardive dyskinesia.

Symptoms of tardive dyskinesia can also include dyskinetic movements of the trunk and hip, including rotational, swaying and thrusting motions. This can affect the spinal column, causing a condition known as lordosis ("saddleback" or "swayback"). This is a condition in which inward, concave curvature of the spine becomes extremely pronounced.

Sources

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).
Dressler D. and R. Benecke. "Diagnosis and Management of Acute Movement Disorders". Journal of Neurology, vol. 252 no. 11 (November 2005).
Kane, John M. "Assessment of Tardive Dyskinesia." Task Force on Tardive Dyskinesia (1992: American Psychiatric Association)
Twycross, Robert G. and Andrew Wilcock. Symptom Management in Advanced Cancer, 3rd ed. (Oxford: Radcliffe Publishing, 2001)

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