Giant Tongue in a Patient With Chiari Malformation and Neuroleptic-Induced Tardive Dyskinesia.

Abstract

A 68-year-old woman, presented with a squamous cell carcinoma of the malar region, and underwent wide local excision. During her clinical examination, repetitive protrusion and intrusion of the tongue as well as stereotypic, abnormal movements of the mouth and lips were observed, in a pattern that resembled chewing, sucking or lip pursing; dyskinesias ceased when she was speaking or bringing food to the mouth. She was unaware of the movements and the tongue was observed to move similar to choreiform movements, while revealing a giant "snake-like" macroglossia. She had history of mental retardation and alcohol abuse, and was under classic antipsychotic medications for several years. During a previous neurological investigation, type I Chiari malformation was diagnosed. In this case, concomitant Chiari malformation and neuroleptic-induced tardive dyskinesia, may together have been responsible for giant macroglossia, and to our best knowledege no similar observation has been reported in the literature.

• Authors: Ricardo Horta, Ricardo Nascimento, Alvaro Silva
• Journal: The Journal of craniofacial surgery (J Craniofac Surg) 2019 Mar/Apr Vol. 30 Issue 2 Pg. e137-e138 ISSN: 1536-3732 [Electronic] United States
• PMID: 30614996 (Publication Type: Case Reports, Journal Article)

Chemical References

• Antipsychotic Agents

Topics

• Aged
• Alcoholism (complications)
• Antipsychotic Agents (adverse effects)
• Arnold-Chiari Malformation (complications)
• Female
• Humans
• Intellectual Disability (complications)
• Macroglossia (etiology)
• Tardive Dyskinesia (chemically induced, complications)