Characteristic Jaw Movements in Tardive Dyskinesia
Tardive dyskinesia characteristically produces rapid, involuntary jaw movements including repetitive chewing motions, lateral jaw deviations, and grinding movements that are choreiform (dance-like) in nature. 1
Primary Orofacial Movement Patterns
The jaw movements in tardive dyskinesia are part of the broader orofacial involvement that defines this disorder:
- Chewing movements are among the most common jaw manifestations, appearing as repetitive, purposeless mastication even when the mouth is empty 1
- These movements occur alongside other facial features including grimacing, tongue movements, and blinking, forming the classic orofacial presentation 1
- The movements are choreiform and athetoid in character—meaning they are irregular, rapid, and flowing rather than rhythmic tremors 1
Movement Characteristics
The jaw dyskinesias have specific qualities that distinguish them from other movement disorders:
- Movements are involuntary and stereotyped, meaning they follow repetitive patterns that the patient cannot voluntarily suppress 2, 3
- They typically involve hyperkinetic (excessive) rather than hypokinetic movements 2
- The jaw movements are irregular and dance-like (choreiform), not tremulous, which helps differentiate tardive dyskinesia from drug-induced parkinsonism 1
Clinical Context and Distribution
- Tardive dyskinesia most commonly affects the orofacial region, making jaw involvement a hallmark feature, though it can extend to limbs and trunk 1, 2
- The mouth, lips, tongue, and jaw are typically involved together as part of the orobuccolingual complex 4
- These movements can be socially stigmatizing and functionally impairing, affecting eating, speaking, and social interactions 5, 3
Important Clinical Pitfall
- Do not confuse tardive dyskinesia jaw movements with acute dystonia or drug-induced parkinsonism—tardive dyskinesia involves choreiform movements, while acute dystonia presents with sustained muscle spasms and parkinsonism presents with tremor and rigidity 1
- This distinction is critical because anticholinergic medications may help parkinsonism but will worsen tardive dyskinesia 6