CONTRIBUTION OF PHYSIOTHERAPY IN PSYCHIATRY: CASE OF A PATIENT SUFFERING OF DYSTONIA DUE TO ANTIPSYCHOTICS AT THE SAINT JOHN OF GOD MENTALHEALTH CENTRE IN LOMÉ-TOGO.

Abstract

Introduction: Antipsychotic-induced dystonia is a neurological side-effect and can be very disabling. Treatment is multidisciplinary, including physiotherapy.

Objective: The aim was to show the contribution of physiotherapy in the management of people suffering from dystonia secondary to antipsychotics.

Method: The Saint John of God Mental Health Centre in Lomé was used as the study setting. This involved a descriptive study about a case of cervical dystonia induced by antipsychotics, from 13 July to 30 August 2020.

Results: Our observation concerned a male patient, aged 55 years, suffering from a persistent delirious disorder, on a poorly documented treatment, admitted for cervical dystonia and persistent delirium. A physiotherapy assessment revealed neck pain rated at 5/10, reduced neck muscle strength, and an inability to keep the neck stable at rest. He was started on olanzapine 20mg tablet a day, haloperidol decanoas injectable 50mg/month, and trihexyphenidyl 5mg tablet in the morning. Physiotherapy treatment consisted of 14 sessions using various techniques including passive-active stretching of the neck and head muscles. The evolution was marked by a significant regression of involuntary neck movements and an improvement in the patient's quality of life.

Conclusion: Physiotherapy should be more involved in the management of dystonia in psychiatric practice.