Tongue base retraction and airway obstruction in drug-induced oromandibular dystonia

A 29-year-old man began haloperidol therapy (1.5 mg/d) for severe agitation due to mental stress. He developed jaw opening dystonia at 1 month, and paroxysmal stridor and dyspnea at rest occurred at 5 months. A fiberscope revealed both involuntary tongue base retraction and airway obstruction (video), suggesting diagnosis of drug-induced oromandibular dystonia. Haloperidol was discontinued. At follow-up 1 year following cessation of haloperidol, he reported gradual disappearance of tongue base retraction within 1 month and the jaw opening dystonia within 4 month. Although tongue base retraction is an uncommon form of oromadibular dystonia,1,2 it is a serious complication of therapy.