What are the causes of piano-playing finger (toe) signs?

Delayed dyskinesia is divided into the following types according to the site of dyskinesia ① abnormal eye muscle movement: blinking, blepharospasm, etc.; ② abnormal facial muscle movement: facial muscle twitching, jerking and sad face, etc.; ③ abnormal mouth muscle movement: pouting, smacking, chewing, suction and lateral jaw movement, etc.; ④ abnormal tongue muscle movement: tongue extension, tongue contraction, wriggling and lip licking, etc.; ⑤ abnormal pharyngeal muscle movement: abnormal palate movement affecting pronunciation and (6) abnormal neck movement: slanting neck, backward neck, etc.; (7) abnormal trunk movement: uncoordinated trunk movement, odd posture, such as shrugging shoulders and retracting back, corkscrew, twisting spasm, diaphragm spasm producing grunting and breathing difficulties, sometimes the whole body swaying from side to side, repeated trunk flexion and extension, back and forth twisting, called body shaking sign; (8) abnormal limb movement: continuous flexion and extension of the distal limbs, called playing piano fingers (toes) sign. The proximal end is rarely involved, and a few show dance-like finger paddling movements, throwing movements, hand and foot squirming-like movements, repeatedly raising the hands or jumping on both legs, etc. What causes late-onset dyskinesia? Most commonly seen in long-term (more than 1 year) high doses of dopaminergic receptor blocking or binding antipsychotic drugs, especially phenothiazines such as chlorpromazine endorphine, butylphenols such as haloperidol can cause TD certain dopamine drugs such as levodopa, methyldopa, pacinin tranquilizers can also cause similar TD health search involuntary movements occasionally seen in long-term use of antidepressants, anti-PD drugs antiepileptic drugs and antihistamines Patients are prone to dose reduction or discontinuation of medication. Related factors include: ① age gender factors: older people are prone to health search, not easy to recover more women than men; ② brain lesion patients using antipsychotics prone to occur, negative symptoms schizophrenia patients with TD early age of onset of high incidence; ③ drug factors health search: drug dose and duration of treatment is associated with the occurrence of TD is mostly seen in patients with Parkinson’s syndrome occurring early in treatment. The first priority is to avoid risk factors. Clinicians should adhere to the following principles: only patients who really need the application of antipsychotics (e.g. schizophrenia) should be given. Antipsychotics should never be used to treat neurosis or depression, much less as a sleeping pill for insomnia. This is because the onset of delayed movement disorder is not related to the size of the drug dose, and can occur even in small amounts. If delayed-onset dyskinesia occurs in a patient with schizophrenia, it should be weighed against the severity of the problem and should not be discontinued hastily.