Transient tardive dystonia: overview and case presentation.
Dystonia is a syndrome of involuntary, repetitive (or sustained) muscle contractions of opposing muscles, which may result in torsions and abnormal postures. Tardive dystonia is a form of the disorder that starts after longer term use of dopamine antagonists. It occurs in approximately 3% of patients receiving ongoing antipsychotic treatment and is often difficult to reverse. Dystonia can also be induced by compounds other than antipsychotics, such as antidepressants, levodopa, carbamazepine, dextroamphetamine, and diphenylhydantoin. In these cases, it is transient, generally disappearing after the dose is reduced or the causative drug is stopped. Dystonia induced by injury can also be transient. We report a case of transient oromandibular dystonia following a dental filling in a woman receiving quetiapine, a second-generation antipsychotic. The timing, localization, and transience of the dystonia suggested that the dental procedure may have played a triggering role. The dystonia symptoms responded within 8 weeks to benztropine and a dose reduction of quetiapine, and they did not return when benztropine was discontinued. This case benefited from prompt attention and has led to practical recommendations for psychiatric clinicians.
Seeman
Mary V
MV
University of Toronto Institute of Medical Science, Toronto, Ontario, Canada M5S1A8. mary.seeman@utoronto.ca
Clodman
David
D
Remington
Gary
G
D003987:Dibenzothiazepines / Q000009:adverse effects*; D004421:Dystonia / Q000139:chemically induced* / Q000150:complications / Q000503:physiopathology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D009069:Movement Disorders / Q000150:complications / Q000209:etiology* / Q000503:physiopathology*; D000069348:Quetiapine Fumarate
D003987:Dibenzothiazepines; D000069348:Quetiapine Fumarate