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If the patient abruptly displays orofacial dyskinesia, review his medication regimen. If he’s taking a phenothiazine or other antipsychotic, withhold the drug if possible, and prepare to give 50 mg of diphenhydramine to reverse the drug’s effects. If he has difficulty swallowing, take precautions necessary to prevent aspiration and choking and have suction equipment on hand.
If the patient’s dyskinesia is chronic, ask when it began. Then obtain a complete drug history. Also, note a history of seizures. Next, closely examine the patient’s dyskinesia. Is it unilateral or bilateral? Does it involve the entire face or only part of it? Are neck muscles involved? Does the patient have any voluntary control over the movements? Characterize the abnormal movements. Are they constant, or repetitive and intermittent? Listen to his speech—does it sound abnormal? Can he swallow?
Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006
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