Hostname: page-component-7479d7b7d-8zxtt Total loading time: 0 Render date: 2024-07-12T05:27:31.075Z Has data issue: false hasContentIssue false

Tourette-like Syndrome Following Low Dose Short-term Neuroleptic Treatment

Published online by Cambridge University Press:  18 September 2015

Samarthji Lal*
Affiliation:
Department of Psychiatry, Montreal General Hospital and Douglas Hospital, Montreal
Esam AlAnsari
Affiliation:
Department of Psychiatry, Montreal General Hospital and Douglas Hospital, Montreal
*
Department of Psychiatry, Montreal General Hospital, 1650 Cedar Avenu, Montreal, P.Q. H3G 1A4
Rights & Permissions [Opens in a new window]

Abstract:

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the ‘Save PDF’ action button.

A Tourette-like syndrome (TLS) may occur after long-term neuroleptic treatment. A review of 11 cases reported in the literature is given. We describe the onset of a TLS in a 13-year old boy with childhood schizophrenia after short term, low-dose treatment with thioridazine. The syndrome resolved 5 months after neuroleptic withdrawal. Subsequent exposure to neuroleptics (mainly perphenazine) induced a recurrence of motor tics and involuntary vocalizations which resolved on drug discontinuation. Awareness that neuroleptics may induce a TLS may lead to prompt recognition and avoidance of labelling the manifestations as symptoms of the underlying psychosis or attention-seeking behaviour.

Type
Original Articles
Copyright
Copyright © Canadian Neurological Sciences Federation 1986

References

REFERENCES

1.Marsden, CD, Tarsy, D and Baldessarini, RJ.Spontaneous and drug-induced movement disorders in psychiatric patients. In: Psychiatric Aspects of Neurologic Disease, Benson, DF and Blumer, D, eds. Grune and Stratton, N.Y. 1975.Google Scholar
2.Tarsy, D, Granacher, R, Bralower, M.Tardive dyskinesia in youngadults. Am J Psychiat 1977; 134: 10321034.Google Scholar
3.Weiner, WJ, Goetz, CG, Nausieda, PA, Klawans, HL.Respiratory dyskinesias: extrapyramidal dysfunction and dyspnea. Ann Int Med 1978; 88: 327331.CrossRefGoogle ScholarPubMed
4.Klawans, HL, Falk, DK, Nausieda, PA, Weiner, WJ.Gilles de la Tourette syndrome after long term chlorpromazine therapy. Neurology 1978; 28: 10641068.CrossRefGoogle ScholarPubMed
5.Klawans, HL, Nausieda, PA, Goetz, CG, Tanner, CM, Weiner, WJ.Tourette-like symptoms following chronic neuroleptic therapy. Adv Neurol 1982; 35: 415418.Google ScholarPubMed
6.Pary, RJ.The ‘psychotic curse’. Am J Psychiat 1979; 136: 715716.Google ScholarPubMed
7.Fog, R, Pakkenberg, H.Theoretical and clinical aspects of the Tourette syndrome (chronic multiple tic). J Neural Transm Suppl 1980; 16: 211215.Google Scholar
8.Fog, R, Pakkenberg, H, Regeur, L, Pakkenberg, B.“Tardive” Tourette syndrome in relation to long-term neuroleptic treatment of multiple tics. Adv Neurol 1982; 35: 419421.Google ScholarPubMed
9.Stahl, SM.Tardive Tourette syndrome in an autistic patient after long-term neuroleptic administration. Am J Psychiat 1980; 137: 12671269.Google Scholar
10.Devaugh-Geiss, J.Tardive Tourette syndrome. Neurology 1980; 30: 562.CrossRefGoogle Scholar
11.Seeman, MV, Patel, J, Pyke, J.Tardive dyskinesia with Tourette-like syndrome. J Clin Psychiat 1981; 42: 357358.Google ScholarPubMed
12.Mueller, J, Aminoff, MJ.Tourette-like syndrome after long-term neuroleptic drug treatment. Brit J Psychiat 1982; 141: 191193.CrossRefGoogle ScholarPubMed
13.Shapiro, AK, Shapiro, ES, Brun, RD, Sweet, RD.Gilles de la Tourette syndrome. Raven Press, N.Y. 1978.Google Scholar
14.Diagnostic and Statistical Manual of Mental Disorders (111). Ameri can Psychiatric Association, Washington, D.C. 1980.Google Scholar
15.Marneros, A.Adult onset of Tourette’s syndrome: a case report. Am J Psychiat 1983; 140: 924925.Google ScholarPubMed
16.Sutula, T, Hobbs, WR.Senile-onset vocal and motor tics. Arch Neurol 1983; 40: 825826.CrossRefGoogle ScholarPubMed
17.Waserman, J, Lai, S, Gauthier, S.Gilles de la Tourette’s syndrome in monozygotic twins. J Neurol Neurosurg Psychiat 1983; 46:7577.CrossRefGoogle ScholarPubMed
18.Klawans, HL, Weiner, W.The effect of d-amphetamine on chorei form disorders. Neurology 1974; 24: 312318.CrossRefGoogle Scholar
19.Gerlach, J, Reisby, N, Randrup, A.Dopaminergic hypersensitivity and cholinergic hypofunction in the pathophysiology of tardive dyskinesia. Psychopharmacologia 1974; 36: 2135.CrossRefGoogle Scholar
20.Fernando, SJM.Six cases of Gilles de la Tourette’s syndrome. Brit J Psychiat 1976; 128: 436441.CrossRefGoogle ScholarPubMed
21.Aran, AM, Freeman, JM, Carter, S.The natural history of Sydenham’s chorea. Am J Med 1965; 38: 8395.CrossRefGoogle Scholar
22.Klempel, K.Gilles de la Tourette’s syndrome induced by L-dopa. S AfrMed J 1974; 48: 13791380.Google ScholarPubMed
23.Golden, GS.The effect of central nervous system stimulants on Tourette syndrome. Ann Neurol 1977; 2: 6970.CrossRefGoogle ScholarPubMed
24.Lowe, TL, Cohen, DJ, Detlor, J, Krementizer, MW, Shaywitz, BA.Stimulant medications precipitate Tourette’s syndrome. J Amer Med Assoc 1982; 247: 17291731.CrossRefGoogle ScholarPubMed
25.Mitchell, E, Mathews, KL.Gilles de la Tourette’s disorder associated with pemoline. Am J Psychiat 1980; 137: 16181619.Google ScholarPubMed
26.Neglia, JP, Glaze, DG, Zion, TE.Tics and vocalizations in children with carbamazepine. Pediatrics 1984; 73: 841844.CrossRefGoogle ScholarPubMed
27.Kaplan, SR, Murkofsky, C.Oral-buccal dyskinesia symptoms associated with low dose benzodiazepine treatment. Am J Psychiat 1978; 135: 15581559.Google ScholarPubMed
28.Chadwick, D, Reynolds, EH, Marsden, CD.Anticonvulsant induced dyskinesias. J Neurol Neurosurg Psychiat 1979; 39: 12101218.CrossRefGoogle Scholar
29.Blowers, AJ.Epidemiology of tardive dyskinesia in the elderly. Neuropharmacology 1981; 20: 13391340.Google ScholarPubMed
30.Campbell, M, Grega, DM, Green, WH, Bennett, WG.Neuroleptic induced dyskinesias in children. Clin Neuropharmacol 1983; 6: 207222.CrossRefGoogle ScholarPubMed