EC Psychology And Psychiatry

Introduction: Lingual dystonia is a rare form of focal dystonia, and the reasons for why it occurs are not yet fully understood. Patients with this movement disorder experience incredible discomfort, distress, social embarrassment, and impaired psychological function.

Case Report: The following report discusses a 23-year-old subject who suffers from lingual dystonia and has multiple comorbidities, with an extensive drug history including various Selective Serotonin Reuptake Inhibitors (SSRIs).

Discussion: Through this case, we understand that there is a correlation between the patient's history and her dystonic attacks. There is a possible linkage between mirtazapine, a noradrenergic and specific serotonergic antidepressant (NaSSA) and other SSRIs to isolated lingual dystonia and other precipitating factors such as anxiety.

Conclusion: Isolated lingual dystonia is an extremely rare, unusual and distressing condition, of which the triggers and causes are not well understood. This case discusses the possible causes of isolated lingual dystonia and highlights the impact it can have on one’s life, necessitating the need to further understand the condition.

 Keywords: Lingual Dystonia; Anxiety Disorder; Noradrenergic and Specific Serotonergic Antidepressant (NaSSA)

1. Jinnah HA and Albanese A. “The new classification system for the dystonias: Why was it needed and how was it accomplished?” Movement Disorders Clinical Practice 4 (2014): 280-284.
2. DL CJFLP. “Functional dystonia differentiation from primary dystonia and multidisciplinary treatments”. Frontiers in Neurology 11 (2021): 605262.
3. Richter A. “Pathophysiology of idiopathic dystonia: findings from genetic animal models”. Progress in Neurobiology6 (1998): 633-677.
4. Albanese A and Lalli S. “Update on dystonia”. Current Opinion in Neurology 4 (2009): 483-490.
5. A Sadnicka., et al. “Dystonia”. British Medical Journal 377 (2020): e062659.
6. Cornett EM., et al. “Medication-induced tardive dyskinesia: A review and update”. Ochsner Journal 2 (2017): 162-174.
7. Lange LM., et al. “Genotype-phenotype relations for isolated dystonia genes: MDS gene systematic review”. Movement Disorders 5 (2021): 1086-1103.
8. Albanese A and Lalli S. “Update on dystonia”. Current Opinion in Neurology4 (2009): 483-490.
9. Yildiz Degirmenci., et al. “Isolated lingual dystonia induced by speaking: a rare form of focal dystonia”. Acta Neurologica Belgica 4 (2011): 360-361.
10. Yousafzai ZA., et al. “Case report: Isolated lingual dystonia”. F1000Research 9 (2020): 314.
11. Johanna Junker., et al. “Quality of life in isolated dystonia: non-motor manifestations matter”. Journal of Neurology, Neurosurgery and Psychiatry (2021).
12. Nilufer Doruk., et al. “Sertraline induced oromandibular dystonia”. Psychiatria Danubina 2 (2021): 191-192.
13. S Mohammad Moosavi., et al. “Acute dystonia due to citalopram treatment: a case series”. Global Journal of Health Sciences 6 (2014): 295-299.
14. Christopher D Stephen., et al. “Functional dystonia: A case-control study and risk prediction algorithm”. Annals of Clinical and Translational Neurology4 (2021): 732-748.
15. Jankovic J. “Tardive and idiopathic oro-mandibular dystonia: a clinical comparison”. Journal of Neurology Neurosurgery, and Psychiatry 2 (2000): 185-190.
16. Jamir Pitton Rissardo., et al. “Mirtazapine-associated movement disorders: A literature review”. Tzu Chi Medical Journal4 (2020): 318-330.
17. Leo RJ. “Movement disturbances associated with SSRIs”. Psychiatric Times 5 (2001).
18. NA Uvais., et al. “Sertraline induced mandibular dystonia and bruxism”. Journal of Family Medicine and Primary Care 4 (2016): 882-884.
19. Robert Joseph Morgan., et al. “Escitalopram-induced progressive cervical dystonia”. Psychosomatics5 (2015): 572-575.
20. Abhimanyu Mahajan., et al. “Cervical dystonia and substance abuse”. Journal of Neurology4 (2018): 970-975.
21. Krystal JH., et al. “Subanesthetic effects of the noncompetitive NMDA antagonist, ketamine, in humans. Psychotomimetic, perceptual, cognitive, and neuroendocrine responses”. Archives of General Psychiatry 3 (1994): 199-214.
22. Volkow ND., et al. “Addiction circuitry in the human brain”. Annual Review of Pharmacology and Toxicology 52 (2012): 321-336.
23. Koob GF and Volkow ND. “Neurocircuitry of addiction”. Neuropsychopharmacology1 (2010): 217-238.
24. Leo RJ. “Movement disorders associated with the serotonin selective reuptake inhibitors”. Journal of Clinical Psychiatry10 (1996): 449-454.
25. Koyama S and Matsumoto S. “Clinical and Phenomenological Characteristics of Patients with Task-Specific Lingual Dystonia: Possible Association with Occupation”. Frontiers in Neurology 8 (2017): 649.
26. Yousafzai ZA., et al. “Case report: Isolated lingual dystonia [version 2 peer review: 3 approved, 1 approved with reservations]”. F1000Research 9 (2021): 314.