Tardive dyskinesia (TD), is a movement disorder produced by long-term use of antipsychotic medication in patients with psychiatric disorders. It mainly manifests as rapid, involuntary, rhythmless, choreographic-like movements or dystonia of the mouth, face, jaw, limbs and trunk. It has received increasing attention in recent years. It occurs mostly in the elderly, especially in women, and is particularly prevalent in older people with organic brain lesions, and is often more symptomatic and slower to recover, as well as in people with emotional disorders. The prevalence in Asia is 16.6% (17.3% in men, 15.8% in women, male:female = 1.1:1). Various antipsychotic drugs can cause it, but the traditional antipsychotic drugs fluphenazine, trifluoperazine and haloperidol, and chlorpromazine are more common, while newer drugs can also occur, but significantly less. Most patients have been taking antipsychotics for more than 1-2 years, with the shortest presentation time being 3 months. The main clinical feature is involuntary, rhythmic, repetitive stereotyped movements. The earliest manifestation is tongue tremor or drooling, characterized by mouth movements in the elderly, and limb involvement is common in younger patients. The most common case is mouth-tongue-cheek triad (BLM syndrome) or cheek, tongue and mastication syndrome: it is characterized by repetitive and uncontrollable movements of the mouth, lips and tongue, such as sucking, tongue turning, tongue licking, chewing, pouting, cheek puffing, crooked jaw, neck turning, etc. Sometimes the tongue suddenly sticks out of the mouth involuntarily, which is called fly-catcher tongue syndrome, and in severe cases, slurred speech and swallowing disorder. In severe cases, there is no clear articulation and swallowing disorder. Other signs include involuntary swinging of the limbs, aimless jerking, dancing finger-like movements, twitchy movements of the hands and feet or twisting movements of the trunk of the limbs. Occasionally, gastrointestinal tract-type tardive dyskinesia may occur, with stomach discomfort, nausea and vomiting following sudden withdrawal of the drug. The severity of the disorder fluctuates, worsens during emotional stress or excitement, and disappears during sleep. Some patients may co-exist with delayed sedentary inability, delayed dystonia, and pharmacogenic Parkinson’s syndrome, and the symptoms are often masked and revealed when the medication is reduced or discontinued. The following types of movement disorders are common according to the site of the movement disorder: 1. Eye muscle movement abnormalities: blinking, blepharospasm. 2, facial muscle movement abnormalities: facial muscle spasm, twitching, sad face. 3, abnormal mouth muscle movement: pouting, smacking, chewing, sucking, lateral movement of the jaw. 4, abnormal tongue muscle movement: tongue extension, tongue retraction, wriggling, lip licking. 5, abnormal movement of pharyngeal muscles: abnormal movement of palate affects pronunciation and swallowing. 6, abnormal neck movement: slanting neck, neck tilting back. 7, abnormal trunk movement: the whole body trunk movement is uncoordinated, in odd postures, such as shrugging shoulders and shrinking back, corkscrew, twisting spasms, diaphragm movement and spasms produce grunting and breathing difficulties; sometimes it is manifested as the whole body swaying from side to side, repeatedly flexing and extending the trunk, twisting back and forth or leaning forward and backward, called bodyrocking). 8, abnormal limb movements: the distal limbs show continuous flexion and extension movements, known as the piano finger (toe) sign, while the proximal end is rarely involved; a few may show dance-like finger paddling movements, throwing movements (such as upper limb throwing ball-like movements), hand and foot sluggish-like movements, repeatedly raising both hands or jumping on both legs. 9, hypotonia-paralysis type movement disorder: can involve the head, neck and waist, such as neck weakness can not lift the head, waist weakness can not straighten, convex abdomen, when walking can not step, can not lift the leg, heel dragging the ground and walking. Acute withdrawal syndrome: involuntary, erratic and non-repetitive choreographic movements occurring when antipsychotic drugs are suddenly discontinued, similar to chorea minor or Huntington’s disease, mostly seen in children, and can heal spontaneously. Gradual reduction of the dose when using antipsychotic drugs can make the choreographic movements disappear gradually. 2. Delayed dystonia: It can occur in both children and adults. Its involuntary movements are manifested as rapid, repetitive stereotyped movements, but are dystonic, similar to torsional dystonia or torsional spasms, and can persist. The risk factors for the occurrence of TD are still inconclusive, and the more consistent view is that age is closely related to the incidence of TD. The older the age, the higher the incidence of TD. One study showed that when small doses of antipsychotics (mean dose equivalent to 68.4 mg/d of chlorpromazine) were given to patients over 45 years of age who had never taken the drug before, TD developed in 5.9% of patients after 3 months, compared with a cumulative incidence of only 4-5% in younger patients taking the drug for 1 year. In addition, gender differences have attracted the attention of most investigators. Most studies have found that the incidence of TD increases with age in female patients, while this tendency is not as pronounced in men. The incidence of TD in women was significantly higher in the 51-70 and over 70 age groups, with the incidence of TD in women over 70 years of age being five times that of women under 50 years of age; whereas the incidence of TD in men over 70 years of age was only two times that of men under 50 years of age. In addition, a number of other factors are considered to be related to the occurrence of TD, such as: mood disorders, organic brain damage, age of the patient at the time of the first dose of antipsychotic drugs, type of drugs taken, cumulative dose of drugs, number of treatment interruptions, presence of acute extrapyramidal side effects, diabetes mellitus, alcohol dependence, negative symptoms, etc. and negative symptoms, among others. However, the results obtained by different researchers vary widely, and some even contradict each other. Some studies have concluded that long-term use of high-dose antipsychotics, especially in combination with anticholinergic drugs, is likely to produce TD; high doses of antipsychotics and the combination of antipsychotics and antiparkinsonian drugs also significantly increase the risk of TD; the number of drug interruptions during antipsychotic treatment is significantly associated with the occurrence of TD, and the incidence of TD is three times higher in those with more than two interruptions than in those with two or fewer interruptions; the cumulative incidence of antipsychotics is three times higher. The incidence of TD was 3 times higher in those with more than 2 interruptions than in those with 2 or less interruptions; cumulative antipsychotic and anticholinergic doses were not correlated with the occurrence of TD. It is generally believed that tardive dyskinesia is often irreversible once it occurs, but data from a 1992 study found no change in TD symptoms in 49.2% of men and 58.9% of women, improvement in TD symptoms in 30.8% of men and 28.8% of women, and worsening of symptoms in the remaining 20% of men and 12.3% of women. Indeed, late-onset movement disorders are more difficult to treat, cannot be eradicated in most patients, and even when they are treated, they are time-consuming. However, the likelihood of cure increases significantly with early treatment, and the earlier the treatment, the better. The following methods can improve the cure rate: rapid discontinuation of the anticholinergic drug Benzedrine hydrochloride, switching to drugs with mild extrapyramidal side effects, and the use of Chinese herbal medicine and acupuncture if available. Previous experience suggests that early treatment with iproniazid has relatively definite efficacy. Other methods are benzodiazepines (f*ck)/(draconian), valproate, calcium channel blockers, psilocybin, opiates, cycloheximide, tryptophan, lithium, manganese, nicotinic acid, and botulinum toxin, but the efficacy is uncertain. The general choice of antipsychotic drugs is quetiapine, clozapine, olanzapine class of drugs as the best, aripiprazole and other drugs with light extrapyramidal side effects can also be chosen. In the process of antipsychotic drug adjustment, the addition of traditional antipsychotics can briefly reduce TD symptoms, but they will soon disappear or even worsen; after switching to new antipsychotics, the symptoms will worsen in the short term, but then they will be reduced; according to experience, the best efficacy of new drugs is quetiapine, but the antipsychotic effect is relatively weak, so patients with unstable conditions should consider carefully.