Tardive Dyskinesia: A Middle-Aged Woman With PTSD, Schizaffective Disorder, and Anxiety

Joohi Jimenez- Shahed, MD

Medical Director, Movement Disorders Neuromodulation & Brain Circuit Therapeutics, Associate Professor, Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai

A 47-year-old woman with a history of post-traumatic stress disorder, schizaffective disorder, and anxiety presents to your office. About 6 months before presentation, she had started experiencing involuntary tongue movements. She reports that her tongue sticks out when she is eating and talking. She drools at night and after eating. Her speech is slurred because of the tongue movements. She has other involuntary movements in her limbs. Her symptoms are constant, cause embarrassment, and interfere with speech and chewing food

Results of a neurologic examination reveal orobuccolingual stereotypies and repetitive lateral jaw movements without overt tongue protrusion, although her tongue is seen to move around at rest when her mouth is open. Speech is slightly dysarthric. There are repetitive finger-rubbing stereotypies.

Upon further questioning, you find out that she is actively taking a combination of an antidepressant and a neuroleptic medication.