LIFE-THREATENING DYSPHAGIA FOLLOWING PROLONGED NEUROLEPTIC THERAPY

We report the cases of two patients with complaints of dysphagia follo wing long-term neuroleptic therapy. Esophageal contrast radiography re vealed that one patient suffered disruption of the normal swallowing a ctivity of the pharyngoesophagus due to tardive dyskinesia. Her dyspha gia disappeared following changes in her neuroleptic medications and t he administration of clonazepam. The other patient demonstrated severe rabbit syndrome involving the glossopharynx. This 3-Hz rhythmic movem ent disorder resolved following injection of an anticholinergic agent. Thereafter, the addition of oral trihexyphenidyl to her medication re gimen improved her dysphagia. It should be emphasized that the differe ntial diagnosis of neuroleptic-associated dysphagia subtypes is import ant because therapeutic strategies differ depending on the subtype of this life-threatening illness.