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Laryngeal tardive dyskinesia

A Fève1, B Angelard, J Lacau St Guily

  • 1Service de Neurochirurgie, Hôpital Henri Mondor, Créteil, France.

Journal of Neurology
|July 1, 1995
PubMed
Summary

Chronic neuroleptic treatment can cause laryngeal dyskinesia, a movement disorder affecting vocal cords. This study found abnormal laryngeal movements in patients with tardive dyskinesias, impacting speech, breathing, and swallowing.

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Area of Science:

  • Neurology
  • Pharmacology
  • Otolaryngology

Background:

  • Neuroleptic medications commonly cause movement disorders, specifically tardive dyskinesias, often affecting the orobuccolingual region.
  • While acute dystonia and breathing issues are known early side effects, laryngeal involvement from chronic neuroleptic use is less understood.

Purpose of the Study:

  • To investigate laryngeal abnormal movements in patients undergoing chronic neuroleptic treatment who exhibit orobuccolingual tardive dyskinesias.
  • To assess the prevalence and nature of laryngeal dysfunction in this patient cohort.

Main Methods:

  • Systematic assessment using the Abnormal Involuntary Movement Scale (AIMS).
  • Clinical examination focusing on speech, breathing, and swallowing functions.
  • Laryngeal endoscopy to visualize vocal cord movement and glottic function.
  • Percutaneous electromyography (EMG) of thyroarytenoid muscles to record muscular activity.

Main Results:

  • 8 out of 12 patients experienced speech disorders, 8 had breathing difficulties, and 5 reported swallowing issues.
  • Laryngeal endoscopy revealed intermittent partial glottic obstruction in 10 patients due to abnormal vocal cord adduction.
  • EMG demonstrated spontaneous, irregular, and prolonged thyroarytenoid muscle contractions at rest and during speech, often unnoticed by patients.

Conclusions:

  • Laryngeal dyskinesia is a potential, often unrecognized, side effect of chronic neuroleptic treatment.
  • These findings suggest that laryngeal movement disorders should be considered in the differential diagnosis of patients with chronic neuroleptic exposure and orobuccolingual dyskinesias.

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