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Advances in the diagnosis and treatment of tardive dyskinesia

Published on October 31, 2024   48 min

A selection of talks on Neurology

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0:00
Good morning. My name is Dr. Stanley N. Caroff. I'm an Emeritus Professor at the University of Pennsylvania, Perelman School of Medicine in Philadelphia, Pennsylvania in the United States. I'll be talking about advances in the diagnosis and treatment of tardive dyskinesia.
0:21
The learning objectives today are to interpret effective screening policies for the early diagnosis of tardive dyskinesia or TD, including patient and caregiver reports. We'll also describe the impact of TD on functioning and quality of life, and finally, construct an individualized treatment plan for patients with TD, including measures of response.
0:48
Now what is tardive dyskinesia or TD? I'm sure many of you are already familiar with this. TD is defined as an involuntary, hyperkinetic movement disorder that's delayed in onset and potentially irreversible even after the triggering drugs are discontinued. The symptoms of TD range in phenomenology, severity, and impact. Now, TD mostly affects the orofacial region in 60-80% of patients, but two or more body regions can be involved in at least half of the cases, so it's important to examine the entire patient's body. TD is most often mild with a total abnormal involuntary movement scale score of less than five in about 70-80% of patients, but it can be moderate or severe with an AIMS greater than six in 20-30% of patients. Now it's important to realize that patients may have two or more drug-induced movement disorders in as many as 20-30% of patients who have a drug-induced movement disorder. For example, TD can also occur with tardive dystonia in 10% of cases in one study and even with the acute reversible drug-induced movements of parkinsonism and akathisia in 13 or 5% respectively.

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