Summary
Definition
History and exam
Key diagnostic factors
- exposure to dopamine receptor-blocking agents
- stereotypic involuntary movements of the mouth and tongue
Other diagnostic factors
- blepharospasm
- dystonia of the trunk and limbs
- tardive myoclonus
- tardive tics (tourettism)
- tardive chorea
- tardive akathisia
- tardive tremor
- tardive parkinsonism
- tardive oral and/or genital pain
Risk factors
- use of dopamine receptor-blocking agents
- age >50 years
- history of acute dystonic reaction, akathisia, or drug-induced parkinsonism with previous medication use
- alcohol and substance misuse
- postmenopause
- smoking
- African-American ethnicity
- diabetes mellitus
- brain injury
- dementia
Diagnostic tests
1st tests to order
- clinical diagnosis
Treatment algorithm
all patients
Contributors
Authors
Joseph Jankovic, MD
Professor of Neurology
Distinguished Chair in Movement Disorders
Director
Parkinson's Disease Center and Movement Disorders Clinic
Department of Neurology
Baylor College of Medicine
Houston
TX
Disclosures
JJ declares that he has no competing interests.
Abhishek Lenka, MD, PhD
Movement Disorders Fellow
Parkinson's Disease Center and Movement Disorders Clinic
Department of Neurology
Baylor College of Medicine
Houston
TX
Disclosures
AL is an Associate Editor for Frontiers in Neurology (Movement Disorders).
Peer reviewers
Mark Stacy, MD
Professor of Neurology
Medical University of South Carolina
Charleston
SC
Disclosures
MS declares that he has no competing interests.
Tabish Saifee, FRCP, PhD
Consultant Neurologist
National Hospital for Neurology and Neurosurgery
London North West University Hospitals NHS Trust
London
UK
Disclosures
TS has received travel reimbursement from Ipsen for attending conferences and for consultancy.
Differentials
- Tic disorder
- Levodopa-induced dyskinesia
- Drug-induced parkinsonism
More DifferentialsGuidelines
- Diagnostic and statistical manual of mental disorders, 5th edition, text revision (DSM-5-TR)
- A modified Delphi consensus study of the screening, diagnosis, and treatment of tardive dyskinesia
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