Wojcik J D, Falk W E, Fink J S, Cole J O, Gelenberg A J
Department of Psychiatry, Massachusetts General Hospital, Boston.
Am J Psychiatry. 1991 Aug;148(8):1055-9. doi: 10.1176/ajp.148.8.1055.
Tardive dystonia, historically combined with tardive dyskinesia, is now viewed as probably having a different pathophysiology, course, outcome, and treatment response than tardive dyskinesia. In addition, patients with tardive dystonia are reported to be younger, and most are men. This study evaluates characteristics of 32 patients with tardive dystonia and compares results to other reports.
Twenty-four patients had been referred for research purposes and were videotaped, while eight had been followed clinically. Two of the authors reviewed all available videotapes and clinical reports to assess the course of symptoms over time. For global ratings and ratings of affected body parts, two scales were used: the Abnormal Involuntary Movement Scale (AIMS) for tardive dyskinesia and a similar scale for tardive dystonia. The method of case finding does not provide incidence or prevalence data for tardive dystonia.
Fifty-nine percent of the patients experienced onset of tardive dystonia symptoms within 6 years of antipsychotic drug exposure; women had a shorter exposure time. No patient had complete remission of tardive dystonia symptoms, and 22 were moderately or severely impaired when their movements were most prominent.
While epidemiological studies of tardive dystonia have yet to be performed, these results support the observations of others that most patients with tardive dystonia are men, have a short history of exposure to antipsychotic drugs, and may initially present with blepharospasm. Tardive dystonia rarely remits completely, can cause notable disability, and may partially respond to anticholinergic agents.
迟发性肌张力障碍在历史上曾与迟发性运动障碍合并，现在被认为其病理生理学、病程、结局及治疗反应可能与迟发性运动障碍不同。此外，据报道迟发性肌张力障碍患者较为年轻，且多数为男性。本研究评估了32例迟发性肌张力障碍患者的特征，并将结果与其他报告进行比较。
24例患者因研究目的被转诊并进行了录像，另外8例为临床随访病例。两位作者审查了所有可用的录像和临床报告，以评估症状随时间的变化过程。对于整体评分和受累身体部位的评分，使用了两种量表：用于迟发性运动障碍的异常不自主运动量表（AIMS）和用于迟发性肌张力障碍的类似量表。病例发现方法未提供迟发性肌张力障碍的发病率或患病率数据。
59%的患者在接触抗精神病药物6年内出现迟发性肌张力障碍症状；女性的接触时间较短。没有患者的迟发性肌张力障碍症状完全缓解，22例在运动最明显时存在中度或重度功能障碍。
虽然尚未进行迟发性肌张力障碍的流行病学研究，但这些结果支持了其他人的观察结果，即大多数迟发性肌张力障碍患者为男性，接触抗精神病药物的时间较短，且最初可能表现为眼睑痉挛。迟发性肌张力障碍很少完全缓解，可导致明显的残疾，并且可能对抗胆碱能药物有部分反应。
