We report two patients with lingual dyskinesia and complaints of food regur
gitation following long-term antipsychotic therapy. Esophageal contrast rad
iography revealed dyskinetic movements extending from the pharynx to the up
per portion of the esophagus. The elevation of intraesophageal pressure was
confirmed by esophageal manometry. The dyskinetic movements almost disappe
ared along with improvement of lingual dyskinesia following the administrat
ion of sulpiride in one patient. Another patient suddenly died due to asphy
xiation of foods before the beginning of treatment. We termed this life-thr
eatening movement, 'esophageal dyskinesia'. It should be emphasized that 'e
sophageal dyskinesia' associated with lingual dyskinesia is a potentially f
atal adverse reaction to antipsychotic therapy. Int Clin Psychopharmacol 14
:123-127 (C) 1999 Lippincott Williams & Wilkins.