A blessing in disguise: Resolution of tardive dyskinesia with development of cervical myelitis
Identifieur interne : 003613 ( Main/Exploration ); précédent : 003612; suivant : 003614A blessing in disguise: Resolution of tardive dyskinesia with development of cervical myelitis
Auteurs : Erle Chuen-Hian Lim [Singapour] ; Einar P. V. Wilder-Smith [Singapour] ; Raymond Chee-Seong Seet [Singapour]Source :
- Movement Disorders [ 0885-3185 ] ; 2006-01.
Descripteurs français
- Pascal (Inist)
English descriptors
- KwdEn :
- Adult, Antipsychotic Agents (adverse effects), Antipsychotic Agents (therapeutic use), Bipolar Disorder (drug therapy), Cervical Vertebrae, Dyskinesia, Dyskinesia, Drug-Induced (diagnosis), Follow-Up Studies, Haloperidol (adverse effects), Haloperidol (therapeutic use), Humans, Male, Myelitis, Myelitis (diagnosis), Myelitis (rehabilitation), Nervous system diseases, Neurologic Examination (drug effects), Osteomyelitis (diagnosis), Osteomyelitis (rehabilitation), Quadriplegia (diagnosis), Quadriplegia (rehabilitation), Remission, Spontaneous, cervical, myelitis, resolution, tardive dyskinesia.
- MESH :
- chemical , adverse effects : Antipsychotic Agents, Haloperidol.
- chemical , therapeutic use : Antipsychotic Agents, Haloperidol.
- diagnosis : Dyskinesia, Drug-Induced, Myelitis, Osteomyelitis, Quadriplegia.
- drug effects : Neurologic Examination.
- drug therapy : Bipolar Disorder.
- rehabilitation : Myelitis, Osteomyelitis, Quadriplegia.
- Adult, Cervical Vertebrae, Follow-Up Studies, Humans, Male, Remission, Spontaneous.
Abstract
Tardive dyskinesia (TD), which is frequently seen in patients treated with dopamine receptor blocking agents, is difficult to manage. We report on a young Chinese man with bipolar disorder who developed TD after haloperidol treatment, involving the trunk, limbs, and orofacial area. TD persisted despite switching to atypical antipsychotic agents and treatment with valproate, benzodiazepines, and tetrabenazine. Resolution only occurred years later when he developed quadriplegia arising from infective myelitis of the cervical cord (C4–5). He had concomitant vertebral osteomyelitis, which was successfully treated with intravenous antibiotics. With intensive rehabilitation, he recovered the use of his limbs, but had no recurrence of TD. We attribute the resolution of orofacial dyskinesias with a cervical lesion to the interconnections between the orofacial area and cervical spine via the trigeminal nucleus (which has fibers descending as far caudally as C6), as well as to resetting of cortical maps. © 2005 Movement Disorder Society
Url:
DOI: 10.1002/mds.20715
Affiliations:
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Le document en format XML
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<term>Bipolar Disorder (drug therapy)</term>
<term>Cervical Vertebrae</term>
<term>Dyskinesia</term>
<term>Dyskinesia, Drug-Induced (diagnosis)</term>
<term>Follow-Up Studies</term>
<term>Haloperidol (adverse effects)</term>
<term>Haloperidol (therapeutic use)</term>
<term>Humans</term>
<term>Male</term>
<term>Myelitis</term>
<term>Myelitis (diagnosis)</term>
<term>Myelitis (rehabilitation)</term>
<term>Nervous system diseases</term>
<term>Neurologic Examination (drug effects)</term>
<term>Osteomyelitis (diagnosis)</term>
<term>Osteomyelitis (rehabilitation)</term>
<term>Quadriplegia (diagnosis)</term>
<term>Quadriplegia (rehabilitation)</term>
<term>Remission, Spontaneous</term>
<term>cervical</term>
<term>myelitis</term>
<term>resolution</term>
<term>tardive dyskinesia</term>
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<term>Haloperidol</term>
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<term>Haloperidol</term>
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<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Dyskinesia, Drug-Induced</term>
<term>Myelitis</term>
<term>Osteomyelitis</term>
<term>Quadriplegia</term>
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<keywords scheme="MESH" qualifier="drug effects" xml:lang="en"><term>Neurologic Examination</term>
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<keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Bipolar Disorder</term>
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<term>Osteomyelitis</term>
<term>Quadriplegia</term>
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<term>Cervical Vertebrae</term>
<term>Follow-Up Studies</term>
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<term>Male</term>
<term>Remission, Spontaneous</term>
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<front><div type="abstract" xml:lang="en">Tardive dyskinesia (TD), which is frequently seen in patients treated with dopamine receptor blocking agents, is difficult to manage. We report on a young Chinese man with bipolar disorder who developed TD after haloperidol treatment, involving the trunk, limbs, and orofacial area. TD persisted despite switching to atypical antipsychotic agents and treatment with valproate, benzodiazepines, and tetrabenazine. Resolution only occurred years later when he developed quadriplegia arising from infective myelitis of the cervical cord (C4–5). He had concomitant vertebral osteomyelitis, which was successfully treated with intravenous antibiotics. With intensive rehabilitation, he recovered the use of his limbs, but had no recurrence of TD. We attribute the resolution of orofacial dyskinesias with a cervical lesion to the interconnections between the orofacial area and cervical spine via the trigeminal nucleus (which has fibers descending as far caudally as C6), as well as to resetting of cortical maps. © 2005 Movement Disorder Society</div>
</front>
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<name sortKey="Wilder Mith, Einar P V" sort="Wilder Mith, Einar P V" uniqKey="Wilder Mith E" first="Einar P. V." last="Wilder-Smith">Einar P. V. Wilder-Smith</name>
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