What are the symptoms? Expand Symptoms of an acute dystonic reaction include: strange movements of the face and/or mouth tongue protrusion head tilts back forced opening of the mouth problems with eating and swallowing eyes turned upward or to the side hyper-extension of the spine Symptoms of tardive dystonia include: strange movements of the face and/or mouth involuntary eye closure voice problems head tilts back involuntary twisting or movement of the neck contortion of the trunk internal rotation of arms, elbow extension, wrist flexing akathisia (feelings of inner restlessness) Symptoms of focal dystonia can occur days or years after exposure to the medication. Stress and anxiety are known to exacerbate the symptoms.
Who does it affect? Expand Tardive dystonia can affect at any age. Tardive dystonia tends to progress in children to involve multiple body parts but remain focal to a specific body area in adults. Acute dystonia is more common in younger patients compared to classic tardive dyskinesias.
What are the causes? Expand Acute dystonic reaction and tardive dystonia are most commonly the result of side effects from a type of medication which is prescribed to treat schizophrenia and psychosis called a ‘dopamine receptor blocker’ (DRB). Some DRBs are also used to treat nausea and dizziness. Many other medications have been reported to cause acute dystonic reactions including: anti-depressants of the type that inhibit the reuptake of serotonin calcium antagonists (sometimes used to treat high blood pressure and angina) some anaesthetic agents anticonvulsants such as carbamazepine and phenytoin illicit drugs such as cocaine and ecstasy Acute dystonia is more often associated with butyrophenone antipsychotics (e.g. haloperidol) compared to phenothiazine antipsychotics (e.g. prochlorperazine and chlorpromazine). Acute dystonic reactions can occur within hours or days of exposure the medication or as a result in changes to the dose of medications while tardive dystonia usually occurs in patients who have been taking these medications for longer than 3 months.
What are the common treatments? Expand The first step is usually a controlled withdrawal of the medication causing the problem. It is important this done under the supervision of a clinician. If it is important for the patient to continue taking DRB medication, then the clinician would be expected to look for different types of DRB medication that hopefully will not cause a further reaction. Other treatments that are used include: oral medication botulinum toxin injections deep brain stimulation
How will it affect my life? Expand You may need to find ways to adapt and might have to learn new ways to complete everyday tasks. However, it is possible to live well with the condition and Dystonia UK is here to support you through all stages including initial onset, diagnosis, finding treatment and beyond. Some people find their symptoms may respond to sensory tricks.