Tardive Dyskinesia Definition

Tardive dyskinesia is a movement disorder that affects a person’s ability to perform voluntary muscular movements. The neurological syndrome is often permanent and untreatable, and can be a serious side effect of long-term use of some neuroleptic medications that affect dopamine receptors in the brain, including medications used to treat schizophrenia, nausea, or vomiting.

Tardive dyskinesia is often hard to diagnose, as its symptoms are similar to many other types of movement disorders, including Parkinson's disease and Tourette syndrome. Patients with tardive dyskinesia experience uncontrollable movements in certain muscles and an inability to remain motionless.

Symptoms of Tardive Dyskinesia

Signs of tardive dyskinesia may include any of the following:

Continuous and repetitive movements of the mouth, tongue, and jaw
Facial grimacing
Lip smacking
Puffing of the cheeks
Uncontrollable movements of the arms, legs, fingers, and toes
Swaying motions of the trunk or hips

Movements of the jaw usually consist of an up-and-down motion, as if a person is chewing. When the tongue is affected, it may protrude or move around in a twisting manner.

Causes of Tardive Dyskinesia

According to an FDA analysis from early 2009, the most common cause of tardive dyskinesia is long-term treatment with metoclopramide, a dopamine receptor antagonist medication prescribed to treat severe nausea, vomiting, migraine headaches, acid reflux, heartburn, and to stimulate lactation in women. Metoclopramide has also been prescribed as an antipsychotic or neuroleptic drug.

Metoclopramide, available as Reglan, Maxolon, Degan, Maxeran, and Primperan, works by inhibiting the delivery of certain messages from the brain to parts of the body. Long-term use of these medications—for longer than three months—has been found to cause tardive dyskinesia, as well as Parkinson’s disease, in some patients.

Tardive Dyskinesia & Similar Disorders

The symptoms of tardive dyskinesia are similar to those of various other movement disorders, including Tourette syndrome. Researchers have found that these two conditions can resemble each other so closely that the disorder "tardive tourettism" was named. Only careful examination of the circumstances surrounding the onset of the disorder can determine which condition is actually present, as tardive dyskinesia symptoms develop only after long-term exposure to certain neuroleptic medications that affect the brain.

Other similar disorders include tardive dystonia, akathisia, and myoclonus. Tardive dystonia is often permanent and drug-related, characterized by muscle spasms and uncontrollable movements in the torso. Akathisia is usually accompanied by inner anxiety and involves the entire body, rather than a particular region. Myoclonus is a condition that causes jerky contractions of a single muscle group.

While there may be challenges in assessing a tardive dyskinesia definition and the condition may resemble other disorders, seeking the opinion of a movement disorder specialist is the recommended course of action for those exhibiting symptoms of tardive dyskinesia.

Tardive Dyskinesia Treatment

Currently, prevention is the best treatment for tardive dyskinesia. Since long-term use of the medication Reglan (metoclopramide) is the most common cause of tardive dyskinesia, the best treatment is to reduce or completely stop use of metoclopramide to prevent and reduce symptoms of tardive dyskinesia.

Once a patient has been diagnosed with tardive dyskinesia, a doctor may reduce their metoclopramide prescription or completely take the patient off of the medication and switch their prescription to another medication. In addition, the doctor may prescribe other medications, such as dopamine agonists, to help ease tardive dyskinesia symptoms.

Ongoing medical research is concerned with establishing the best treatment methods for tardive dyskinesia, but changing the patient’s medication or prescribing dopamine agonists seems to be the treatment of choice suggested by most medical professionals.

Sources:

http://www.nami.org/Content/ContentGroups/Helpline1/Tardive_Dyskinesia.htm
http://www.bcm.edu/neurology/patient_education/pdcmdc/td.html
http://my.clevelandclinic.org/disorders/tardive_dyskinesia/hic_tardive_dyskinesia.aspx

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