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Tardive dyskinesia with inflated neurons of the cerebellar dentate nucleus

Case reports and morphometric study

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Summary

Four autopsied cases of tardive dyskinesia manifesting oral hyperkinesia revealed markedly inflated neurons in the cerebellar dentate nucleus (DN), which had not been described previously. The inflation of the neurons was proved to be statistically significant (P<0.01) by morphometric study. The nuclei were usually situated in the central portion of the cytoplasm. This inflated change was different from both central chromatolysis and grumose degeneration of the DN, typically observed in progressive supranuclear palsy and dentatorubropallidolysian atrophy, and seemed to be easy to miss without careful observation, since neuronal loss and gliosis were very mild in the DN. Among a few autopsied cases of tardive dyskinesia reported previously, degeneration of the DN was described in only two. It is believed, however, that the inflated neurons of the DN may not be so rare and may be related to the occurrence of some involuntary hyperkinesia, especially oral hyperkinesia following some neurotoxic disorders and/or neuroleptic medications.

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References

  • Ananth J (1979) Drug induced dyskinesia: a critical review. Int Phamacopsychiatry 14:21–33

    Google Scholar 

  • Ansell GB (1981) The biological background to tardive dyskinesia. Neuropharmacology 20:311–317

    Google Scholar 

  • Anzil AP (1969) Progressive supranuclear palsy, case report with pathological findings. Acta Neuropathol (Berl) 14:72–76

    Google Scholar 

  • Arai N, Nagatomo H, Kuwahara H, Amano N, Yokoi S, Saito A, Kobori H, Yoshihara R (1984) An autopsied case of tardive dyskinesia with degenerative dentate nucleus (in Japanese). Seishin Igaku (Clinical Psychiatry) 27:425–430

    Google Scholar 

  • Chan-Palay V (1977) Cerebellar dentate nucleus. Springer, Berlin Heidelberg New York, pp 25–41

    Google Scholar 

  • Christensen E, Möller JE, Faurbye A (1970) Neuropathological investigation of 28 brains from patients with dyskinesia. Acta Psychiatr Scand 46:14–23

    Google Scholar 

  • Forrest FM, Forrest IS, Roizin L (1963) Clinical, biochemical and postmortem studies in a patient treated with chlorpromazine. Agressologie 4:259–267

    Google Scholar 

  • Gross H, Kaltenbäck E (1968) Neuropathological findings in persistent dyskinesia after neuroleptic long-term therapy. In: Cerletti A, Bove RJ (eds) The present status of psychotropic drugs. Excepta Medica, Amsterdam, pp 474–476

    Google Scholar 

  • Grünthal E von, Wälther-Büel H (1960) Über Schädigung der Oliva inferior durch Chlorperphenazin (Trilafon). Psychiatr Neurol 140:249–257

    Google Scholar 

  • Hunter R, Blackwood W, Smith MC, Cumings JN (1968) Neuropathological findings in three cases of persistent dyskinesia following phenothiazine medication. J Neurol Sci 7:263–273

    Google Scholar 

  • Iwase S (1974) An autopsy case of tardive dyskinesia (in Japanese). Saishin Igaku (Tokyo) 29:306–312

    Google Scholar 

  • Jellinger K (1977) Neuropathologic findings after neuroleptic long-term therapy. In: Roizin L, Shiraki H, Greevic N (eds) Neurotoxicology. Raven Press, New York, pp 25–42

    Google Scholar 

  • Jeste DV, Wyatt RJ (1981) Changing epidemiology of tardive dyskinesia: an overview. Am J Psychiatry 138:297–309

    Google Scholar 

  • Kaufman MA (1977) Alternative diagnoses to tardive dyskinesia: neuropathological findings in three suspected cases. In: Roizin L, Shiraki H, Greevic N (eds) Neurotoxicology. Raven Press, New York, pp 57–61

    Google Scholar 

  • Klawans HL (1973) The pharmacology of tardive dyskinesia. Am J Psychiatry 130:82–86

    Google Scholar 

  • Okumura A, Oda M, Iwase S, Shiraki H (1975) Pathomorphological and clinicopathological study of so-called grumose degeneration in the cerebellar dentate nucleus (in Japanese). Adv Neurol Sci (Tokyo) 19:483–497

    Google Scholar 

  • Poursines Y, Alliez J, Toga M (1959) Syndrome parkinsonien consécutif à la prise prolongée de chlorpromazine avec ictus mortel intercurrent. Rev Neurol (Paris) 100:745–752

    Google Scholar 

  • Rasmussen S, Kristensen M (1977) Choreoathetosis during phenytoin treatment. Acta Med Scand 201:239–241

    Google Scholar 

  • Roizin L, True C, Knight M (1959) Structural effects of transquillizers. Ass Res Nerv Ment Dis Proc 37:285–324

    Google Scholar 

  • Shiraki H, Matsushita M (1982) Alteration of cerebellar dentate nucleus (grumose alteration: “GA”) and tardive dyskinesia induced by neuroleptics (in Japanese). Shinkei Seishin Yakuri (Tokyo) 4:547–568

    Google Scholar 

  • Shiraki H, Okumura A, Oyanagi S (1977) Neuropathology of “grumose degeneration” of the cerebellar dentate nucleus with special reference to certain neurotoxic disorders and other pathological processes. In: Roizin L, Shiraki H, Greevic N (eds) Neurotoxicology. Raven Press, New York, pp 43–55

    Google Scholar 

  • Sigwald J, Bouttier D, Raymondeaud C, Piot C (1959) Quatre cas de dyskinesie facio-buccolingo-masticatrice à évolution prolongée secondaire à un traitement par les neuroleptiques. Rev Neurol (Paris) 100:751–755

    Google Scholar 

  • Tarsy D, Baldessarini RJ (1977) The pathophysiologic bases of tardive dyskinesia. Biol Psychiatry 12:431–450

    Google Scholar 

  • Ungerstedt U (1971) Postsynaptic supersensitivity after 6-hydroxydopamine induced degeneration of the nigrostriatal dopamine system. Acta Physiol Scand [Suppl 367] 82:69–93

    Google Scholar 

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Arai, N., Amano, N., Iseki, E. et al. Tardive dyskinesia with inflated neurons of the cerebellar dentate nucleus. Acta Neuropathol 73, 38–42 (1987). https://doi.org/10.1007/BF00695500

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  • DOI: https://doi.org/10.1007/BF00695500

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