Dyskinesia, also known as tardive dyskinesia (TD), is a neurological disorder often caused by the long-term use of neuroleptic drugs. Such drugs are generally prescribed for psychiatric disorders, as well as for some gastrointestinal and neurological disorders.

TD involves involuntary movements of the lips, tongue, mouth and face. These excess movements also may be experienced by people with Parkinson’s disease.

The movements can become more diffuse and can resemble generalized jitteriness, chorea or dystonias. Akithisia, a form of restlessness, is often associated with TD and manifests itself as constant fidgeting or a necessity to keep moving.

Elderly women appear to be the most susceptible to developing TD from neuroleptics.

Tardive Dyskinesia Symptoms

Symptoms include movements that have continuous, repetitive and stereotyped patterns. Such movements include lip smacking, grimacing, blinking and grunting. You may also have rapid movements of the arms, legs and trunk.

Tardive Dyskinesia Treatment

With tardive dyskinesia, the first step of treatment may be to discontinue or alter the neuroleptic drug.

Injections of botulinum toxin may be the most desirable therapy. The drug weakens certain muscles and lasts several months.

Therapies may be necessary to help patients with language and movement.

Tardive Dyskinesia Treatment: Surgical Options

Deep brain stimulation (DBS) is a procedure where electrodes are placed in specific areas of the brain. The electrodes block the abnormal brain circuitry seen in patients with neurological conditions such as Parkinson’s disease, essential tremors, dystonia and dyskinesia.

DBS does not destroy the overactive cells, like other movement disorders treatments such as pallidotomy and thalamotomy surgeries. Rather, it temporarily blocks the abnormal signals and is a reversible process. In DBS, a lead is permanently implanted into your brain and connected to a generator, which is attached under the skin of your chest.

An alternative to making a lesion with an electrode is to use highly focused radiation. Two types of devices can be used to deliver stereotactic radiosurgery, namely the Gamma Knife® and the LINAC-Scalpel.

Wake Forest Baptist Multidisciplinary Approach

The treatment of movement disorders at Wake Forest Baptist is a collaborative effort between neurologists and neurosurgeons.

Quality of life is further enhanced by the participation of physical, occupational and speech therapists, and otolaryngologists who have special expertise in speech and swallowing difficulties.