Several different disorders resemble tardive dyskinesia. Doctors attempt to rule out other causes before confirming a diagnosis of tardive dyskinesia. There are no definitive diagnostic tests to detect tardive dyskinesia; if necessary, tests will be conducted to rule out other possible causes of the symptoms.

Observation

The first step in diagnosing tardive dyskinesia is observing the patient. Ideally health care providers will be able to do this several times at different times of the day, because the frequency of symptoms may vary across time. Detailed notes will be taken.

Typically, tardive dyskinesia produces grimaces and other facial distortions, such as a protruding tongue. Facial contortions may resemble someone with loose or poor- fitting dentures. The arms, hands, and legs are also typically involved. Movements are jerky or slow and writhing.

When did the problem begin?

While the doctor or other health provide is observing the patient, he or she will ask several question of both the patient and the patient’s family. The doctor will ask when the problem began. This question helps pinpoint any possible causative agents for the problem, such as neuroleptics or metoclopramide. Both you and your family or regular caregiver will be asked about the beginning of symptoms, because patients with the disorder frequently do not initially realize that abnormal movements are occurring.

Typically, tardive dyskinesia will occur after three months or more of treatment with neuroleptics, but in people age 65 or older, the symptoms may appear within a month after beginning the drug. This time table is roughly the same for other tardive dyskinesia-inducing drugs such as metoclopramide (trade names: Reglan, Octamide, Maxolon). Symptoms of tardive dyskinesia may also first appear up to four weeks after the drug is discontinued.


Does the movement cause pain?

Tardive dyskinesia can cause pain, particularly in the mouth and the genitals. Assessing whether or not the patient has pain is an important part of the diagnostic process.


What other medical conditions do you have?

Many other medical problems can produce some of the symptoms of tardive dyskinesia. For example, Parkinson’s disease also produces involuntary movements and these may resemble tardive dyskinesia. Hyperthyroidism can produce the jerky limb movements seen in tardive dyskinesia. Answering questions about your medical conditions as thoroughly as you can, will help doctors determine what your current problems are due to.


Do you wear dentures? Do your dentures or teeth bother you?

Ill-fitting dentures and problems with your natural teeth can cause some of the mouth contortions (constant chewing, puckering, opening and closing the lips) seen in tardive dyskinesia, so your health care provider will want to rule out these simple causes before deciding that the problem is more serious.


Have you ever experienced head trauma or a serious infection? Have you been diagnosed with atherosclerosis (hardening of the arteries)?

Brain injury from an accident or illness can cause symptoms similar to tardive dyskinesia. The symptoms present in tardive dyskinesia originate in the part of the brain called the basal ganglia. Damage to this area by an infectious disease such as encephalitis or a condition such as cerebral vascular disease can cause movement disorders similar to drug-induced tardive dyskinesia.


What medications are you taking and what have you taken in the past?
Years ago, medication-related tardive dyskinesia was usually only seen in people who had been given some form of a neuroleptic— a class of medicine used to treat psychiatric disorders, especially schizophrenia. Today, a wide-variety of medications can induce tardive dyskinesia, including amphetamines, antihistamines, and medicines known as antiemetics.
Antiemetics are given to prevent nausea, vomiting, acid reflux, gastroparesis, and other digestive disorders. Metoclopramide is an antiemetic especially prone to cause tardive dyskinesia; its primary use is for gastroparesis. Metoclopramide is sold under the brand names: Reglan, Octamide, and Maxolon. Prochlorperazine, which is used as an antiemetic to stop severe vomiting, is also used to reduce the symptoms of schizophrenia and anxiety disorder; prochlorperazine can cause tardive dyskinesia. It was sold under the brand names: Compro, Compazine, and Stemetil. Compazine is no longer made; currently prochlorperazine is available as a generic drug.


How long have you taken these medicines?
Typically tardive dyskinesia symptoms appear after a person has taken for three months or more the medication which is causing the problem; however, those age 65 and older can develop tardive dyskinesia after only a month on the medication. Surprisingly, tardive dyskinesia symptoms can first appear several weeks after a medication has been discontinued.


What conditions have other family members suffered with?

Some hereditary conditions can cause symptoms similar to tardive dyskinesia. Doctors will want to know if any of your family members suffer from (or suffered from) Huntington’s disease, Wilson’s disease, or torsion dystonia. Huntington’s disease is an inherited degenerative condition passed from parent to child. Wilson’s disease is a very rare inherited condition which causes excess copper to accumulate in the liver. Torsion dystonia is an inherited movement disorder characterized by severe contractions.

Things You May be Asked to Do

During an evaluation for tardive dyskinesia you may asked to perform certain movements. For example, you may be asked to stick your tongue out and keep it out for a few seconds. Although protruding the tongue is a typical movement found in tardive dyskinesia, most people with the disorder are unable to deliberately hold their tongue out for a period of time.

You will also be asked to remove you shoes and socks so that the movement of your feet and toes can be better observed. You may be asked to stop the movements of your tongue, mouth, fingers, and so on; typically, people with tardive dyskinesia can stop the movements for a brief period of time if they are asked to do so. You may be asked to remain perfectly still for a few minutes. If you have tardive dyskinesia, you may find this difficult to do.

Confirming a diagnosis of Tardive Dyskinesia

After observing you and obtaining your medical and family history, your doctor may be able to determine with a fair degree of accuracy that you have tardive dyskinesia. If the diagnosis is uncertain, the doctor may order diagnostic tests such as a CT scan, an MRI, and EEG to rule out causes such as brain tumors.

If medication-induced tardive dyskinesia is confirmed, the first step in your treatment will be to see you can be taken off the medication causing the problem. Many times a substitute medication can be used. Sometimes the dosage may be reduced. Oddly enough, when tardive dyskinesia is caused by a neuroleptic, increasing the dosage may reduce the symptoms, but this is generally just a temporary solution.

Some people may experience complete relieve from tardive dyskinesia once the causal medication is discontinued; unfortunately, most people will continue to experience symptoms of tardive dyskinesia, even after going off the offending medication. The symptoms may decrease overtime, but they do not go away entirely. You may want to consult a Reglan Lawyer.

The best treatment for tardive dyskinesia is simply prevention. Caution should be used when prescribing any drug which causes this movement disorder. Particular care should be used with people over age 65 because they are more prone to develop tardive dyskinesia; people over 65 can develop tardive dyskinesia after a month or less on the causal medication. Be aware of possible side effects when taking any medication and take medication only according to your doctor’s directions. If you have questions or concerns about a particular medication talk with your doctor or pharmacist.

Treating tardive dyskinesia is difficult. Most studies of various treatment options show mixed results. There is no definitive treatment for tardive dyskinesia.