Tardive dyskinesia ”TD”

1. TARDIVE DYSKINESIA ”TD” ‫الغامدي‬ ‫هللا‬ ‫غرم‬ ‫فارس‬

2. OBJECTIVES
:
Definition of Tardive dyskinesia
Causes of Tardive dyskinesia
Pathophysiology of Tardive dyskinesia
Deferential diagnosis of Tardive dyskinesia
Investigations for Tardive dyskinesia
Treatment of Tardive dyskinesia
Prevention of Tardive dyskinesia

4. DEFINITION OF TD :
Tardive dyskinesia
(TD) is involuntary
movements of the
tongue, lips, face,
trunk, and
extremities

5. CAUSES OF TD :
 Drugs :
TD can be caused by long-term treatment with antipsychotic
“dopamine antagonists”
“anticholinergic drugs”
 GENS :
TD has been associated with polymorphisms of
the dopamine D3 receptor Ser9Gly
the serotonin 2A [1] and 2C receptor genes.

6. PATHOPHYSIOLOGY OF TD :
 The dopamine supers sensitive theory
 The dopamine-acetycholine balance theory

7. DEFERENTIAL DIAGNOSIS OF TD :
Chorea
Epilepsy
Syphilis
Essential Tremor
Thyroid diseases
HIV-1 Associated Cerebrovascular Complications

8. INVESTIGATIONS OF TD :
Usually the investigation to exclude the other disease in DDx
- Thyroid function tests
- Serum biochemistry
CT, MRI, SPECT, and PET
Findings from brain CT and MRI are typically normal in patients with
TD.
patients with TD may demonstrate increased glucose metabolism in
the globus pallidus and the precentral gyrus

9. TREATMENT OF
TD :
 According to “American
Academy of Neurology”
-clonazepam for TD as first
line treatment
-The drug amantadine might
help treat TDS short-term
-The drug tetrabenazine might
help treat TDS

10. PREVENTION OF TD :
 The only certain method of TD prevention is to avoid treatment with
antipsychotic drugs and metoclopramide.
 The use of antipsychotic drugs, particularly for > 3 months,
requires careful evaluation and should be limited to situations
 it is important to inform patients of the risk of developing TD
before treating with antipsychotic drugs

11. SUMMARY :
Definition
Causes
Pathophysiology
Deferential diagnosis
Investigations
Treatment
Prevention

12. SOURCES :
https://www.medicalnewstoday.com/articles/320175.php
https://emedicine.medscape.com/article/1151826-overview#a10
https://www.aan.com/Guidelines/Home/GetGuidelineContent/614
https://www.good-
sam.com/assets/uploads/general/Tardive_dyskinesia_prevention.pdf