Abnormal mouth movements

We were so convinced that many patients were aware of their symptoms but unwilling to report them that toward the end of the project we started to ask patients at the completion of the examination if they noticed any abnormal movements in other patients. Several of the patients described the symptoms of tardive dyskinesia in other patients in great detail. Although it is conceivable that these patients might have been unaware of their own tongue or mouth movements, it is difficult to see how they could not have observed their own hand, feet, or leg movements. 

The efficacy and safety of buspirone have been evaluated in the management of anxiety and irritability in 22 children with pervasive developmental disorders. One child developed abnormal involuntary movements of the mouth, cheeks, and tongue after having taken buspirone 20 mg/day for 10 months. No other drugs were prescribed. The abnormal movements disappeared completely within 2 weeks of withdrawal of buspirone. Other adverse effects... 

Abnormal involuntary movements frequently accompany optimal improvement with levodopa. The duration and the dose are related to the occurrence of these movements so that up to 73% of patients have them after 12 months of treatment. Abnormalities are seen earliest in the head and mouth, then later in the limbs and trunk, sometimes becoming violent and severe. Usually they can be reversed by lowering the levodopa dose or by adding other drugs (phenothiazines, haloperidol or pyridoxine) but with both approaches some therapeutic benefit is often lost. 

Diphasic dyskinesia is described, when 3/4 hours after the dose of levodopa and lasting for 30—60 minutes, abnormal violent movements of limbs occur with retrotorsion of the head and neck, open mouth, forced vocalization and sometimes repetition of words and phrases (64 ). Twelve parkinsonian patients on long-term levodopa therapy developed intermittent myoclonic body jerks. The movements consisted of single unilateral or bilateral abrupt jerks of the extremities and occurred most frequently during sleep (65 "). After 5 years on levodopa 3 g daily a 52-year-old man developed dysphonia which occurred at the peak of activity of the drug (66 ). 

Patients who have received neuroleptics for long periods of time may develop a hyperkinetic disorder of the extrapyramidal system characterized by involuntary, purposeless movements affecting many parts of the body. This is known as tardive dyskinesia. Most commonly, these are manifested in a syndrome involving abnormal movements of the tongue, mouth and masticatory muscles. There are also choreoathetoid movements of the extremities. The mechanism by which these symptoms develop remains unknown. 

Potentially irreversible, late onset, extrapyramidal hyperkinetic movement disorder often associated with the long-term administration of neuroleptics. Abnormal movements generally involve the mouth, lips and tongue. 

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