Struggling to breathe: Respiratory Dyskinesia demystified

So Dr. Chepke, um, can you first give us a brief explanation of respiratory dyskinesia and how it differs from traditional TD?

Well, so really the thing about tardive dyskinesia is, is that it is widely heterogeneous.

It can look completely different in different people.

It can affect almost any part of the body, and it's not just muscles we can see.

You know, the most common forms of TD are in the, in the face, the oral-buccal-lingual TD, but it can affect any muscle in the body, including muscles we can't see, such as the diaphragm, the intercostal muscles that are in between the ribs, and that's where TD can manifest sometimes with respiratory symptoms and be a respiratory dyskinesia.

So imagine, for instance, that, uh, there's a-- the diaphragm, of course, as it contracts, that's what forces our, uh, lungs to empty.

As we breathe in, it has to relax in order to accommodate the air that goes in.

But imagine as we're trying to take a, a breath in that, uh, we have-- the person has an involuntary dyskinetic movement.

The diaphragm cinches up and then all of a sudden they're not able to take that breath in.

They might feel like they're choking or gasping or struggling to breathe.

Could manifest as difficulty breathing.

Or if it happens w- uh, when the, the lungs are inflated and it just is a, a kind of a rapid contraction, it can force the air up out through the, the larynx, through the mouth, and can cause wheezing, gasping, even grunting, uh, uh, various noises.

So there's a wide variety of presentations that just respiratory dyskinesia can take and, uh, uh, and i-is most often accompanied by the s- symptoms of tardive dyskinesia in other parts of the body.

Uh, only rarely does it happen in isolation, uh, and without any other, uh, noticeable tardive dyskinesia in any other part of the person's body.

Wow.