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Tardive and chronically recurrent oculogyric crises

P Sachdev1

  • 1Neuropsychiatric Institute, Prince Henry Hospital, Little Bay, Sydney, Australia.

Movement Disorders : Official Journal of the Movement Disorder Society
|January 1, 1993
PubMed
Summary
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This study reports on chronically recurrent oculogyric crises (OGC) in schizophrenic patients, finding a 4% prevalence. These drug-induced OGC episodes can persist after medication cessation and present with diverse neurological and psychiatric symptoms.

Area of Science:

  • Neurology
  • Psychiatry
  • Pharmacology

Background:

  • Oculogyric crises (OGC) are a type of dystonia.
  • Neuroleptic medications are commonly used for schizophrenia.
  • Tardive side effects can occur with long-term neuroleptic use.

Observation:

  • Six patients with chronically recurrent OGC were identified.
  • Four cases (4% prevalence) were found in 100 schizophrenia patients on maintenance neuroleptic medication.
  • Three patients developed OGC as a tardive side effect; one experienced persistent OGC after drug cessation.

Findings:

  • Recurrent OGC occurred in a notable percentage of neuroleptic-treated schizophrenia patients.
  • OGC episodes were linked to other dystonic movements and varied psychiatric symptoms, including obsessions and hallucinations.

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  • Drug-induced OGC can manifest as a complex disorder affecting movement, thought, behavior, and emotion.

    • Implications:

    • There is a need for greater recognition of chronically recurrent and tardive OGC.
    • Drug-induced OGC may present multifacetedly, mimicking symptoms seen in historical conditions like encephalitis lethargica.
    • Clinicians should consider OGC in patients with schizophrenia experiencing movement and psychiatric disturbances, especially during or after neuroleptic treatment.