Child Develops Muscle Disorder After Administration Of Antipsychotic Drug

Case Overview

This case involves a 11-year-old boy who presented with an uncontrollable shoulder shrug after returning from a school field trip. Tourettes Syndrome was suspected and he was administered an antipsychotic. Following the administration of the medication, the patient developed severe involuntary muscle contractions in his arms and one leg, allegedly as a complication of the antipsychotic use. An expert in pediatric neurology was sought to review the case and provide an opinion on causation.

Questions to the Pediatrics expert and their responses

Are there specific diagnostic criteria for Tourette Syndrome? If so, please explain.

My experience in Tourette's syndrome dates back to my residency training. As such, I have 25+ years of experience in diagnosing and treatment of this disorder. In addition, I have a Ph.D. in pharmacology and have lectured neuropharmacology since then. I have 20 years of academic pediatric neurology practice experience in my institution where Tourette's syndrome is encountered weekly. I have lectured periodically to internists and pediatricians on Tourette's syndrome and neuroleptics use.

What are the probable causes of Tardive Dystonia?

Neuroleptics use could cause Tardive Dystonia, especially chronic use. I use neuroleptics frequently for my patients, although currently, I use mostly safer atypical neuroleptics.

About the expert

This expert has over 20 years of experience in the field of pediatric neurology. She earned her MD from Shanghai Medical University and her PhD in pharmacology from the University of Medicine and Dentistry of New Jersey. After completing her residency in pediatrics at the State University of New York Upstate Medical Center, she finished a second residency and fellowship in pediatric neurology at Johns Hopkins University. Today, this expert is board certified in sleep medicine and neurology, with a special qualification in child neurology. She is active in her field as a member of the American Academy of Sleep Medicine and the Society for Child Neurology of New Jersey. As well, she has published over 50 peer-reviewed publications and 4 book chapters in her field. This expert previously was an associate professor of neurosciences at the University of Medicine and Dentistry of New Jersey, an attending physician at Tomorrow's Children's Hospital, and a consulting neurologist at Matheny School and Hospital. Currently, she is an attending physician at two hospitals, a physician in the division of neurology and pediatric neurology at a major university-affiliated hospital, and a professor of neurology at a top medical school in New Jersey.