Tardive dystonia

Introduction
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By L Giselle Aguilar Tábora MD

Of the tardive syndromes that occur after exposure to dopamine receptor blocking agents, tardive dystonia occurs more rarely and is refractory to medical treatment within frequent occurrence of spontaneous remissions. In this clinical summary, Dr. Aguilar Tábora of The Neurology Center of Southern California, Oceanside, CA, provides updated definition and classification and reviews the basic principles of diagnosis and management. Although long-term use is the most common setting, tardive dystonia has been known to develop after brief exposure and can last only a matter of weeks. Deep brain pallidal stimulation has been used successfully and offers an alternative to those patients who have not shown response to medical therapy.

Key Points

  • Tardive dystonia occurs after exposure to dopaminergic blocking agents, usually after long-term exposure, and may not improve despite discontinuation of the offending agent.
  • The effects of tardive dystonia are often disabling and compromise quality of life due to abnormal movements and the pain produced by these.
  • Medical treatment of tardive dystonia, including discontinuation of the dopaminergic-blocking agent, is often symptomatic with the goal of decreasing pain and dystonic spasms.
  • Deep brain stimulation has emerged as a therapeutic modality, with reports of rapid response, consistent amelioration of tardive dystonia, and improvement in quality of life.

In This Article

Introduction
Historical note and nomenclature
Clinical manifestations
Clinical vignette
Etiology
Pathogenesis and pathophysiology
Epidemiology
Prevention
Differential diagnosis
Diagnostic workup
Prognosis and complications
Management
Anesthesia
References cited
Contributors