Espectro del Síndrome Tardío: Fenomenología, Diagnóstico y Tratamiento

Jose Mauricio Cárdenas , Lina Maria Arango , Ramiro Andrés Gasca , Manuel Alejandro Zúñiga
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Abstract

Our aim with this study was to compile the available scientific evidence on tardive syndromes, their phenomenology, diagnosis and treatment. For this, a systematic review of the literature was carried out by searching indexed databases (PsycINFO, OvidMEDLINE, PubMed, EMBASE, and Scielo), for articles published from January 2009 to March 2020. Tardive syndromes are a group of movement disorders caused by prolonged exposure to dopamine receptor blocking drugs. They typically appear several months and even years after starting the medication and persist for at least one month after discontinuing the drug. Orofacial dyskinesias have classically been described, but the phenomenological spectrum is wide, including dystonia, chorea, tics, myoclonus and akathisia. Treatment is indicated when symptoms interfere with activities of daily living, including withdrawing the offending drug, while the underlying pathologies allow it, changing to another neuroleptic, or considering pharmacological management. In cases refractory to conventional treatment, functional surgery with globus pallidus deep brain stimulation has shown efficacy for tardive dystonia, although with limited evidence.

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晚期综合征的频谱:现象学、诊断和治疗
我们这项研究的目的是汇编有关迟发性综合征、其现象学、诊断和治疗的现有科学证据。为此,我们通过检索索引数据库(PsycINFO、OvidMEDLINE、PubMed、EMBASE 和 Scielo),对 2009 年 1 月至 2020 年 3 月期间发表的文章进行了系统性的文献综述。迟发性综合征是一组因长期接触多巴胺受体阻断药物而引起的运动障碍。它们通常在开始服药数月甚至数年后出现,并在停药后持续至少一个月。口面部运动障碍是经典的描述,但其现象范围很广,包括肌张力障碍、舞蹈症、抽搐、肌阵挛和肌萎缩。当症状影响到日常生活时,就需要进行治疗,包括在潜在病理条件允许的情况下停用违规药物、换用另一种神经安定剂或考虑药物治疗。对于常规治疗无效的病例,尽管证据有限,但使用球状苍白球深部脑刺激的功能性手术对迟发性肌张力障碍有一定疗效。
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来源期刊
Revista Colombiana de Psiquiatria
Revista Colombiana de Psiquiatria Medicine-Psychiatry and Mental Health
CiteScore
2.50
自引率
0.00%
发文量
72
期刊介绍: Revista Colombiana de Psiquiatría (RCP) is a quarterly official publication of Colombian Psychiatry Association (March, June, September and December) and its purpose is to spread different the knowledge models that currently constitute the theoretical and practical body of our specialty. Psychiatrists, psychiatric residents, non psychiatric physicians, psychologists, philosophers or other health professionals or persons interested in this area can take part in the magazine. This journal publishes original works, revision or updating articles, case reports of all psychiatry and mental health areas, epistemology, mind philosophy, bioethics and also articles about methodology of investigation and critical reading.
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