Tardive Dyskinesia?

[nurseygrrl]

I have an 84 year old pt. Dx: NIDDM, S/P MI, BKA R Leg, PVD, Anxiety, Reflux, HTN

Meds:

Neurontin

Protonix

Reglan

Isordil

Glucotrol

Xanax

Percocet PRN

Celexa

He has recently been exhibiting tardive dyskinisia-like symptoms. Sticking out tongue, making weird shapes with his mouth, clicking his teeth, sniffling a lot. He also claims to have severe pain in his jaw. More or less he looks like he wants to jump out of his skin with anxiety, but then again he even does this in his sleep. He's been seen by all depts. and no one can figure out the problem. His xanax (0.25mg) was upped to QID from BID with no change. Also, his Neurontin was D/Cd shortly before these symptoms appeared and he was put back on 4 days ago again with no change. I have been taking care of this man for almost 1 1/2 years and have never seen him like this. Other than the aforementioned, there have been no med changes. This all started about 3 weeks ago with his complaining of a sore throat and tongue.

I would appreciate any suggestions as he is at his wits end and I feel so bad for him.

Thanks in advance!

[caffine addict]

Do you think it may be early Huntington's Chorea?

I've seen Docs TX various choreas with high doses of vitimin E with some positive results however if it's Huntingtons he will need to see Neuro and the Movement disorders people.

We used high doses of vit. E for a resident with true TD and her oral movements improved 75% now we are able to understand her when she talks.

[nurseygrrl, LPN]

Thanks for the info caffine addict...I will look into the vitamin E therapy. Sadly, my patient is leaving us next week. He has decided to go elsewhere because he can't get any straight answers. He said he will be sad because he really cares for me and his CNAs, but he says he can't go on like this anymore

Whatever happens, I hope he finds an answer...poor thing.