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Long term results of unilateral posteroventral pallidotomy for antipsychotic drug induced tardive dyskinesia
  1. M W P M Lenders1,
  2. H P J Buschman1,
  3. M D I Vergouwen2,
  4. E N H J Steur3,
  5. P Kölling4,
  6. M Hariz5
  1. 1Department of Neurosurgery, Medical Spectrum Twente, Enschede, The Netherlands
  2. 2Department of Neurology, Academic Medical Center, Amsterdam, the Netherlands
  3. 3Department of Neurology and Movement Disorder Unit, Medical Spectrum Twente, Enschede, The Netherlands
  4. 4Department of Psychiatry, Medical Spectrum Twente, Enschede, The Netherlands
  5. 5Unit of Functional Neurosurgery, Institute of Neurology, Queens Square, London, UK
  1. Correspondence to:
 Dr H P J Buschman
 Department of Neurosurgery, Medisch Spectrum Twente, PO Box 50 000, 7500 KA Enschede, The Netherlands;

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Tardive dyskinesia (TD) is a well known side effect of neuroleptic drug treatment, and may coexist with tardive dystonia.1 It can be treated with several drugs, although they rarely lead to a complete removal of symptoms. The main treatment of TD consists of gradual neuroleptic drug dose reduction and where possible complete withdrawal.2 Nevertheless, in 40% of TD cases, symptoms do not disappear within 5 years of drug withdrawal. Wang et al first described a pallidotomy as a treatment modality for TD.3 In severe cases of TD and dystonia, this can lead to significant amelioration of abnormal movements and pronounced improvement in function and quality of life.4


We report a 51 year old, chronically hospitalised man with a 29 year history of schizophrenia. During this period, he was treated successfully for his psychotic symptoms with depot haloperidol and cisordinol. In 1993, he developed TD. Initially it consisted of an involuntary tic (myoclonus-like movements of the orofacial muscles), referred to in the literature as tardive tic.5 Both hands showed dyskinetic and myoclonic movements, the left hand less pronounced than the right, and there was severe …

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  • Competing interests: none declared

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