Medscape is available in 5 Language Editions – Choose your Edition here.


Tardive Dystonia Differential Diagnoses

  • Author: Daniel Schneider, MD, MA; Chief Editor: Iqbal Ahmed, MBBS, FRCPsych(UK)  more...
Updated: Aug 12, 2015

Diagnostic Considerations

Friedreich ataxia

Lesch-Nyhan syndrome

Metachromatic leukodystrophy

Perinatal injury

Differential Diagnoses

Contributor Information and Disclosures

Daniel Schneider, MD, MA Assistant Professor of Neurology, Division of Movement Disorders and Behavioral Neurology, Medical Director for Neurologic and Psychiatric Deep Brain Stimulation, Rutgers Robert Wood Johnson Medical School

Disclosure: Nothing to disclose.


Paula D Ravin, MD Associate Professor of Clinical Neurology, University of Massachusetts Memorial Health Care

Paula D Ravin, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, Massachusetts Medical Society, American Headache Society, National Headache Foundation

Disclosure: Received grant/research funds from Chelsea Pharmaceuticals for independent contractor; Received grant/research funds from Kyowa Pharma for independent contractor; Received consulting fee from Best Doctors Inc for consulting; Received grant/research funds from Beth Israel IRB for independent contractor.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Chief Editor

Iqbal Ahmed, MBBS, FRCPsych(UK) Faculty, Department of Psychiatry, Tripler Army Medical Center; Clinical Professor of Psychiatry, Uniformed Services University of the Health Sciences; Clinical Professor of Psychiatry, Clinical Professor of Geriatric Medicine, University of Hawaii, John A Burns School of Medicine

Iqbal Ahmed, MBBS, FRCPsych(UK) is a member of the following medical societies: Academy of Psychosomatic Medicine, American Neuropsychiatric Association, American Society of Clinical Psychopharmacology, Royal College of Psychiatrists, American Association for Geriatric Psychiatry, American Psychiatric Association

Disclosure: Nothing to disclose.

Additional Contributors

Alan D Schmetzer, MD Professor Emeritus, Department of Psychiatry, Indiana University School of Medicine

Alan D Schmetzer, MD is a member of the following medical societies: American Academy of Addiction Psychiatry, American Academy of Clinical Psychiatrists, American Academy of Psychiatry and the Law, American Association for Physician Leadership, American Medical Association, American Psychiatric Association, International Society for ECT and Neurostimulation, American Neuropsychiatric Association

Disclosure: Nothing to disclose.


The authors and editors of Medscape Reference gratefully acknowledge the contributions of previous authors, Nestor Galvez-Jimenez, MD, and Perla Periut, MD, to the development and writing of this article.

  1. Bhidayasiri R, Fahn S, Weiner WJ, Gronseth GS, Sullivan KL, Zesiewicz TA. Evidence-based guideline: treatment of tardive syndromes: report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology. 2013 Jul 30. 81(5):463-9. [Medline].

  2. Burke RE, Fahn S, Jankovic J, et al. Tardive dystonia: late-onset and persistent dystonia caused by antipsychotic drugs. Neurology. 1982 Dec. 32(12):1335-46. [Medline].

  3. Adityanjee, Aderibigbe YA, Jampala VC, Mathews T. The current status of tardive dystonia. Biol Psychiatry. 1999 Mar 15. 45(6):715-30. [Medline].

  4. Kiriakakis V, Bhatia KP, Quinn NP, Marsden CD. The natural history of tardive dystonia. A long-term follow-up study of 107 cases. Brain. 1998 Nov. 121 (Pt 11):2053-66. [Medline].

  5. Fahn S, Marsden, CD, Calne DB. Classification and Investigation of Dystonia. Marsden CD, Fahn S. Movement Disorders, Vol. 2. London: Butterworths; 1987. 332-358.

  6. Fahn, Stanley and Jankovic, Joseph. Principles and Practice of Movement Disorders. Philadelphia, PA: Churchill Livingston Elveiser; 2007.

  7. Stacy, Mark A. Handbook of Dystonia. New York, NY: Informa Healthcare; 2007.

  8. Keegan DL, Rajput AH. Drug induced dystonia tarda: treatment with L-dopa. Dis Nerv Syst. 1973 Mar. 34(3):167-9. [Medline].

  9. Kang UJ, Burke RE, Fahn S. Tardive dystonia. Adv Neurol. 1988. 50:415-29. [Medline].

  10. Sachdev P. Risk factors for tardive dystonia: a case-control comparison with tardive dyskinesia. Acta Psychiatr Scand. 1993 Aug. 88(2):98-103. [Medline].

  11. Mihara K, Kondo T, Higuchi H, Takahashi H, Yoshida K, Shimizu T. Tardive dystonia and genetic polymorphisms of cytochrome P4502D6 and dopamine D2 and D3 receptors: a preliminary finding. Am J Med Genet. 2002 Aug 8. 114(6):693-5. [Medline].

  12. Trugman JM, Leadbetter R, Zalis ME, Burgdorf RO, Wooten GF. Treatment of severe axial tardive dystonia with clozapine: case report and hypothesis. Mov Disord. 1994 Jul. 9(4):441-6. [Medline].

  13. Yassa R, Nair V, Iskandar H. A comparison of severe tardive dystonia and severe tardive dyskinesia. Acta Psychiatr Scand. 1989 Aug. 80(2):155-9. [Medline].

  14. Friedman JH, Kucharski LT, Wagner RL. Tardive dystonia in a psychiatric hospital. J Neurol Neurosurg Psychiatry. 1987 Jun. 50(6):801-3. [Medline].

  15. Sethi KD, Hess DC, Harp RJ. Prevalence of dystonia in veterans on chronic antipsychotic therapy. Mov Disord. 1990. 5(4):319-21. [Medline].

  16. Gimenez-Roldan S, Mateo D, Bartolome P. Tardive dystonia and severe tardive dyskinesia. A comparison of risk factors and prognosis. Acta Psychiatr Scand. 1985 May. 71(5):488-94. [Medline].

  17. Burke RE. Neuroleptic-induced tardive dyskinesia variants. Lang AE, Weiner WJ, eds. Drug-Induced Movement Disorders. New York, NY: Futu; 1992. 168-98.

  18. Vandel P, Bonin B, Leveque E, et al. Tricyclic antidepressant-induced extrapyramidal side effects. Eur Neuropsychopharmacol. 1997 Aug. 7(3):207-12. [Medline].

  19. Gabellini AS, Pezzoli A, De Massis P, Sacquegna T. Veralipride-induced tardive dystonia in a patient with bipolar psychosis. Ital J Neurol Sci. 1992 Oct. 13(7):621-3. [Medline].

  20. Chakrabarti S, Chand PK. Lithium - induced tardive dystonia. Neurol India. 2002 Dec. 50(4):473-5. [Medline].

  21. Chase TN, Tamminga CA, Burrows H. Positron emission tomographic studies of regional cerebral glucose metabolism in idiopathic dystonia. Adv Neurol. 1988. 50:237-41. [Medline].

  22. Arai N, Amano N, Iseki E, et al. Tardive dyskinesia with inflated neurons of the cerebellar dentate nucleus. Case reports and morphometric study. Acta Neuropathol (Berl). 1987. 73(1):38-42. [Medline].

  23. Kaufman DM. Use of botulinum toxin injections for spasmodic torticollis of tardive dystonia. J Neuropsychiatry Clin Neurosci. 1994 Winter. 6(1):50-3. [Medline].

  24. Hennings JM, Krause E, Bötzel K, Wetter TC. Successful treatment of tardive lingual dystonia with botulinum toxin: case report and review of the literature. Prog Neuropsychopharmacol Biol Psychiatry. 2008 Jul 1. 32(5):1167-71. [Medline].

  25. Shapleske J, Mickay AP, Mckenna PJ. Successful treatment of tardive dystonia with clozapine and clonazepam. Br J Psychiatry. 1996 Apr. 168(4):516-8. [Medline].

  26. Blake LM, Marks RC, Nierman P, Luchins DJ. Clozapine and clonazepam in tardive dystonia. J Clin Psychopharmacol. 1991 Aug. 11(4):268-9. [Medline].

  27. Trottenberg T, Volkmann J, Deuschl G, Kühn AA, Schneider GH, Müller J. Treatment of severe tardive dystonia with pallidal deep brain stimulation. Neurology. 2005 Jan 25. 64(2):344-6. [Medline].

  28. Zhang JG, Zhang K, Wang ZC. Deep brain stimulation in the treatment of tardive dystonia. Chin Med J (Engl). 2006 May 5. 119(9):789-92. [Medline].

  29. Thobois S, Ballanger B, Xie-Brustolin J, Damier P, Durif F, Azulay JP, et al. Globus pallidus stimulation reduces frontal hyperactivity in tardive dystonia. J Cereb Blood Flow Metab. 2008 Jun. 28(6):1127-38. [Medline].

  30. Gruber D, Trottenberg T, Kivi A, Schoenecker T, Kopp UA, Hoffmann KT, et al. Long-term effects of pallidal deep brain stimulation in tardive dystonia. Neurology. 2009 Jul 7. 73(1):53-8. [Medline].

All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.