Dyskinesias in childhood, differential diagnosis and treatment. About a case

Abstract

Introduction Dyskinesias are motor disorders that occur as a side effect to treatment with typical and less frequently with atypical antipsychotic drugs. They are more frequents in child population. Treatment usually consists of decrease the dose of drug or replace it with a better profile tolerability antipsychotic. Clozapine is an antipsychotic drug indicated as second-generation treatment of motor disorders that appear as side effects to treatment with neuroleptics. Objectives Demonstrate the efficacy and tolerability of clozapine in the treatment of dyskinesias in childhood. Methods The patient 12 year-old boy, has episodes of psychomotor agitation once a month. This will alternate with quiet moments in which dyskinetic movements are observed in upper limbs, without being able to detect any type triggering environmental factor. Personal history: hydrocele, diagnosed at 8 years becomes neurodevelopmental disorder considered. Neurosurgery tracking for Subarachnoid cyst. Psychopathological examination: Child presents psychomotor restlessness, disruptive behavior, impairments in communication, movement disorder, stereotypies and dyskinetic movements in shoulder and neck. Results In the patient suffering from an autistic disorder, stereotypies and other motor symptoms were observed, the predominant and most relevant being dyskinetic movements in the shoulder and neck, which appeared one month after starting treatment with risperidone and worsening psychomotor skills. Treatment of dyskinesia with clozapine improved the motor symptoms presented by the patient. Conclusions Clozapine should be the treatment of choice in the event of dyskinesias as a secondary effect to other antipsychotic treatments, proving effective in controlling them as well as well tolerated in both adults and children. Disclosure No significant relationships.

Keywords

• Dyskinesias
• stereotypies
• autism
• Antipsychotics