Tardive Dystonia

Excerpt

Extrapyramidal symptoms (EPS) were first witnessed in the 1950s following the discovery of the then-novel class of medication known as neuroleptics. Manifestations of EPS were first officially reported at the “Swiss Symposium on Chlorpromazine” in 1953. The therapeutic efficacy of this new drug class, in parallel with its extrapyramidal activity, resulted in the designation of the term “neuroleptic,” as these drugs were primarily thought to aid in calming psychomotor agitation. It was initially thought EPS manifested promptly after neuroleptic administration. However, subsequent latent motor abnormalities would challenge these assumptions.

In 1957, Schoenecker submitted the first report of what would later be identified as “tardive dyskinesia” as he described the bucco-oral movements of a patient on chronic neuroleptic therapy. It was he who articulated the distinction between this latent phenomenology and acute extrapyramidal side effects. In 1964, the term “tardive dyskinesia” was officially implemented into the psychiatric vernacular, by Faurbye. In 1973, Keegan and Rajputa offered “dystonia tarda” to the psychiatric nosology, following the account of a female patient with latent torticollis. This initial report was, in turn, followed by a comprehensive description in 1982, formally identifying the phenomenon known as “tardive dystonia.” Dystonias are defined as involuntary movement disorders that are distressing and often painful. They are characterized by twisting and repetitive postures resulting from transient or intermittent spasms of antagonistic muscle groups.