Q: I see these commercials about tardive dyskinesia. What is it?
A: Tardive dyskinesia (TD) is one of a group of nervous system conditions that result in involuntary muscle movements.
“Tardive” means late or delayed, while “dyskinesia” is the reference to involuntary movements. Mental Health America estimates that 500,000 people in the U.S. are affected by the condition.
TD is a side effect of taking certain medications that treat issues such as mental illness, neurological disorders or stomach problems. These medicines block dopamine, a brain chemical that helps muscle movement. However, the condition may not present itself immediately. In some instances, symptoms of TD may not appear until after a year or more of taking the medications.
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Symptoms of TD include rapid eye blinking, wiggling of fingers, frowning, lip smacking or tapping of feet. Less common issues related to TD are problems breathing, difficulty swallowing or irreversible facial changes such as drooping eyelids. TD is more common in women or older adults, although anyone taking these medications could develop the condition.
Lowering medication dosage or changing the medication for the specific issue is one method of treating TD. Medications also may be prescribed to help relieve TD symptoms. Physical or speech therapy may be another option.
Contact your health care provider to develop a treatment plan.
Q: How is atrial fibrillation treated?
A: Atrial fibrillation (AFib) is a type of heart arrythmia. An arrythmia occurs when the heart beats too fast, too slowly or in an irregular manner. AFib is when the upper chambers of the heart are not in sync with the lower chambers, which causes chaotic heart rhythm and affects the movement of blood between the chambers.
AFib is the most common type of heart arrythmia. The three main types of AFib are paroxysmal (lasts less than a week), persistent (lasts more than a week) and long-standing (lasts more than a year). In some instances, AFib is permanent.
Structural issues in the heart are the most common cause of AFib. However, the risk of AFib increases with age, and those with high blood pressure, diabetes and who are obese also are more at risk.
Symptoms of AFib include chest pain, dizziness, fatigue, palpitations and shortness of breath. Many who have the condition have no symptoms and are unaware they have AFib.
Blood clots, which can lead to a stroke, are a complication of AFib. Treatments include beta blockers to slow the heart rate and blood thinners to prevent blood clots. If you experience persistent symptoms, contact your health care provider for an examination.
Q: What is spinal muscular atrophy?
A: Spinal muscular atrophy (SMA) is a form of muscular dystrophy. SMA is an inherited, progressive condition that affects motor nerve cells in the spinal cord and causes muscles to weaken to the point where they can no longer be used. SMA is most common in children but can also affect adults.
SMA is caused by a mutation in the survival motor neuron gene, which produces a protein critical to motor neurons. About 60% of people with SMA have Type 1 (severe), with symptoms generally appearing at birth or within the first six months. Type 2 SMA (intermediate) may occur between six and 18 months of age. Type 3 SMA (mild) appears after 18 months. Type 4 SMA (adult) may not present itself until after age 30.
Progressive muscle weakness is the main symptom of SMA. Other symptoms include difficulty rising from a lying or sitting position and frequent falls.
There is no cure for SMA or any other type of muscular dystrophy. Current treatments include corticosteroids to aid muscle strength and delay the progression of the condition. Range of motion and stretching exercises, along with aids such as braces or walkers, also may be recommended.
Q: What causes thyroid eye disease?
A: Thyroid eye disease (TED) is an autoimmune disorder that causes inflammation in connective tissue, fatty tissue and muscles around the eye. Those affected with TED often have Graves’ disease, an autoimmune disorder affecting the eyes, skin and thyroid.
The American Thyroid Association estimates that about one-third of people with Graves’ disease will also develop TED.
TED normally occurs in two phases — active and stable. The active phase, in which inflammation is more noticeable and prominent, can last for several months or as long as three years. The stable phase is when inflammation stops. TED affects women more than men, as women are more likely to be affected by thyroid problems.
Symptoms of TED include bulging eyes, difficulty fully closing the eyes, double vision, puffy eyelids or redness in the eyes. TED symptoms normally occur in both eyes, but it is possible for only one eye to be affected. TED is not contagious.
An eye exam is required to diagnose TED. Nonmedical treatments for the condition include wearing sunglasses, using eye drops or raising your head while lying down to relieve pressure on the eyes. Corticosteroids may be prescribed to reduce swelling. Contact your health care provider if you have questions.
Dr. Daniel Knight is a professor in the Department of Family and Preventive Medicine in the College of Medicine at the University of Arkansas for Medical Sciences. Email your health questions to housecall@uams.edu.