Alexia Duarte1, Helio Afonso Ghizoni Teive2
1Universidade Federal do Paraná, 2Neurology Department, Universidade Federal do Parana
Objective:
The aim of our study was to determine which drugs cause secondary lingual dystonia.
Background:
Lingual dystonia is a type of focal movement disorder characterized by tongue muscles involuntary contractions or abnormal postures maintenance. It can be primary or secondary to a number of conditions, including trauma, autoimmune diseases, viral infections, and medication use. Even though there are many case reports about lingual dystonia secondary to drugs, there is no review, to our knowledge, about the most common drugs causing it.
Design/Methods:
A search was performed by the authors in the PubMed/Medline database. The descriptor used was “lingual dystonia”, and no filters were applied. All of the articles found had their abstract read. Exclusion criteria were articles that did not specify the clinical features of lingual dystonia, that did not expose data clearly separating tongue dystonia from other types, and studies that did not analyze lingual dystonia secondary to medication use.
Results:
Forty-two subjects from 39 case-reports matched our inclusion criteria. The mean age was 39.42 years old (± 20.36; ranging from 6 to 80), and the female to male ratio found was 25:17. Haloperidol (7) and metoclopramide (7) were the two medication most correlated with lingual dystonia, followed by multiple antipsychotics associations (5), risperidone (3), ziprasidone (3), chloroquine (2), lithium (1), levodopa (1), perphenazine (1), cisapride (1), primozide (1), betahistine (1), nitric oxide (1), propofol (1), meperidine (1), compazine (1), methotrimeprazine (1), cyclizine (1), aripiprazole (1) general anesthetics (1) and antidepressants (1).
Conclusions:
The findings of this review suggest antipsychotics and anti-emetic medication are the leading causes of lingual dystonia secondary to medication. Age and sex appear not to be a predisponent factor. Further studies may be helpful to evaluate influence of dosage in symptoms occurrence.