Skip to main content
SpringerLink
Log in

Tardive Dyskinesia and Problems of Assessment

  • Chapter
Current Themes in Psychiatry 2

Abstract

Tardive dyskinesia (TD) is a movement disorder first described by Schonecker in 1957. Although spontaneous cases do occur it is most frequently a drug-induced phenomenon. The syndrome was slow to be recognised, partly perhaps because of the natural resistance of clinicians to accept any iatrogenic condition (Crane, 1973a). In addition TD was largely confined to psychotic patients in long-stay wards, probably the population attracting the least intensive medical involvement. Superficially the abnormal movements may resemble schizophrenic stereotypies and clinically the condition is easily overlooked especially as patients rarely complain spontaneously (Paulson, 1975).

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 39.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 54.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • Alien, R. E. and Stimmel, G. L. (1977). Neuroleptic dosage, duration and T.D. Dis. Nerv. Syst., 38, 385–387

    Google Scholar 

  • American College of Neuropsychopharmacology — Food and Drug Administration Task Force (1973). Neurologic syndromes associated with anti-psychotic drug use. New Engl. J. Med., 289, 20–23

    Article  Google Scholar 

  • Ayd, F. J., Jr. (1970). Prevention of recurrence (maintenance therapy). Clinical Handbook of Psychopharmacology (Ed. A. DiMascio and R. I. Schader), Science House, New York, pp. 297–310

    Google Scholar 

  • Birket-Smith, E. (1974). Abnormal involuntary movements induced by anticholinergic therapy. Acta neurol. scand., 50, 801–811

    Article  CAS  PubMed  Google Scholar 

  • Bockenheimer, S. and Lucius, G. (1976). Zer Therapie mit Dimethyl Aminoethanol (Deanol) bei Neuroleptikain Duzierten Extrapyramidalen Hyperkinesen. Arch. Psychiat., 222, 69–75

    Article  CAS  Google Scholar 

  • Bourgeois, M. and Herbert, A. (1970). Les Dyskinesies Tardives des Neuroleptiques. Bord. Med., 3, 345–352

    CAS  PubMed  Google Scholar 

  • Brandon, S., McClelland, H. A. and Protheroe, C. (1971). A study of facial dyskinesia in a mental hospital population. Br. J. Psychiat., 118, 171–184

    Article  CAS  Google Scholar 

  • Brandrup, E. (1961). Tetrabenazine treatment in persisting dyskinesia caused by psychopharmaca. Am. J. Psychiat., 118, 551–552

    Article  CAS  PubMed  Google Scholar 

  • Bucci, L. (1971). The dyskinesias: a new therapeutic approach. Dis. Nerv. Syst., 32, 324–327

    CAS  PubMed  Google Scholar 

  • Carroll, B. J., Curtis, G. C. and Kokmen, E. (1977). Paradoxical response to dopamine agonists in tardive dyskinesia. Am. J. Psychiat., 134 (7), 785–789

    Article  CAS  PubMed  Google Scholar 

  • Carruthers, S. G. (1971). Persistent tardive dyskinesia. Br. Med. J., 3, 572

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Casey, D. E. (1977). Deanol: a survey of opinions by experts. Convulsive Ther. Bull., 2 (3), 50–51

    Google Scholar 

  • Casey, D. E. and Denney, D. (1975). Deanol in the treatment of T.D. Am. J. Psychiat., 132, 8

    Google Scholar 

  • Chadwick, D., Reynolds, E. H. and Marsden, C. D. (1976). Anticonvulsant induced dyskinesias: a comparison with dyskinesias induced by neuroleptics. J. Neurol. Neurosurg. Psychiat., 39, 1210–1218

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Claveria, L. E., Teychenne, P. F., Caine, D. B. et al. (1975). Tardive dyskinesia treated with pimozide J. nurol. Sci., 24, 393–401

    Article  CAS  Google Scholar 

  • Crane, G. E. (1968). T.D. in patients treated with major neuroleptics. Am. J. Psych., 124 (Suppl.), 40–48

    Article  Google Scholar 

  • Crane, G. E. (1971a). More on amantidine in tardive dyskinesia. New Engl. J. Med., 285, 1150–1151

    CAS  PubMed  Google Scholar 

  • Crane, G. E. (1971b). Persistence of neurological symptoms due to neuroleptic drugs. Am. J. Psychiat., 127, 1407–1410

    Article  CAS  PubMed  Google Scholar 

  • Crane, G. E. (1973a). Persistent dyskinesia. Br. J. Psychiat., 122, 395–405

    Article  CAS  Google Scholar 

  • Crane, G. E. (1973b). Rapid reversal of tardive dyskinesia. Am. J. Psychiat., 130, 11–59

    Article  Google Scholar 

  • Crane, G. E. (1975). Deanol for tardive dyskinesia. New Engl. J. Med., 292, 926–928

    Article  Google Scholar 

  • Crane, G. E., Ruiz, P., Kernohan, W. J., et al. (1969). Effects of drug withdrawal in tardive dyskinesia. Activitas nerv. sup., 11, 30–35

    CAS  Google Scholar 

  • Crane, G. E., Turek, I. S. and Kurland, A. A. (1970). Failure of pyridoxine to reduce drug-induced dyskinesias. J. Neurol. Neurosurg. Psychiat., 33, 511–512

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Dalen, P. (1973). Lithium therapy in Huntington’s chorea and tardive dyskinesia. Lancet i 107–108

    Article  Google Scholar 

  • Davis, K. L., Berger, P. A. and Hollister, L. E. (1975). Choline for tardive dyskinesia. New Engl. J. Med., 293, 152

    CAS  PubMed  Google Scholar 

  • Davis, K. L., Berger, P. A. and Hollister, L. E. (1977). Deanol in tardive dyskinesia. Am. J. Psychiat., 134, 807

    Article  CAS  PubMed  Google Scholar 

  • Davis, K. L., Hollister, L. E., Barchas, J. D., et al. (1976). Choline in T.D. and Huntington’s disease. Life Sci., 19, 1507–1516

    Article  CAS  PubMed  Google Scholar 

  • Decker, B.L., Davis, J.M., Janowsky, D. S.,et al. (1971). Amantidine hydrochloride treatment of tardive dyskinesia. New Engl. J. Med., 285, 860

    CAS  PubMed  Google Scholar 

  • Degkwitz, R. and Wenzel, W. (1976). Persistent extrapyramidal side effects after long term application of neuroleptics. Neuropsychopharmacology (International Congress series 129)

    Google Scholar 

  • Degkwitz, R., Wenzel, W., Binsack, K. F., Herkert, H. and Luxenburger,O. (1966). Zum Probleme Der Terminalen Extrapyramidalen Hyperkinesen an Hand von 1600 Langfristig mit Neuroleptica Behandelten. Artzneimittel Forschung 16 276–278

    CAS  Google Scholar 

  • DeSilva, L. and Huang, C. Y. (1975). Deanol in tardive dyskinesia. Br. med. J., 3, 466

    Article  CAS  Google Scholar 

  • Dynes, J. B. (1970). Oral dyskinesias, occurrence and treatment. Dis. Nerv. Syst. 31 854–859

    CAS  PubMed  Google Scholar 

  • Eckmann, F. (1968). Zur Problematik von Dauerschaden nach neuroleptischer langzeit Behandelung. Ther. Ggw., 107, 316–323

    PubMed  Google Scholar 

  • Ehrensing, R. H., Kastin, A. H., Larsons, P. F. and Bishop, G. A. (1977). Melanocytestimulating-hormone-release-inhibiting-factor I and tardive dyskinesia. Dis. Nerv. Syst., 38 (4), 303–307

    CAS  PubMed  Google Scholar 

  • Escobar, J. I. and Kemp, K. F. (1975). Dimethylaminoethanol for tardive dyskinesia. New Engl. J. Med., 292, 317–318

    Article  CAS  PubMed  Google Scholar 

  • Fann, W. and Lake, C. R. (1974). On the coexistence of parkinsonism and tardive dyskinesia. Dis. Nerv. Syst., 35, 324–326

    CAS  PubMed  Google Scholar 

  • Fann, W., Lake, C. R., Gerber, C. J. et al. (1974). Cholinergic suppression of tardive dyskinesia. Psychopharmacologia, 37, 101–107

    Article  CAS  PubMed  Google Scholar 

  • Fann, W., Lake, C. R. and McKenzie, G. M. (1974). Proceedings: adrenergic and cholinergic factors in extrapyramidal disorders. Psychopharmac. Bull., 10 (3), 52–53

    CAS  Google Scholar 

  • Fann, W., Stafford, J. R., Malone, R. L., Frost, J. D. and Richman, B. W. (1977). Clinical research techniques in tardive dyskinesia. Am. J. Psychiat., 134 (7), 759–762

    Article  CAS  PubMed  Google Scholar 

  • Fann, W. E., Sullivan, J. L. and Richman, B. W. (1976). Dyskinesias associated with tricyclic antidepressants. Br. J. Psychiat., 128, 490–493

    Article  CAS  Google Scholar 

  • Farrar, W. B. (1976). Using electromyographic biofeedback in treating orofacial dyskinesia. J. Prosthet. Dent., 35, 384–387

    Article  CAS  PubMed  Google Scholar 

  • Faurbye, A., Rasch, P. J., Peterson, P. B., Brandborg, G. and Pakkenberg, H. (1964). Neurological symptoms in pharmacotherapy of psychoses. Acta psychiat. stand., 40, 10–27

    Article  CAS  Google Scholar 

  • Gardos, G., Cove, J. O. and Sniffen, C. (1976). An evaluation of papaverine in tardive dyskinesia. J. clin. Pharmac., 16, 304–310

    Article  CAS  Google Scholar 

  • Gerlach, J., Reisby, N. and Randup, A. (1974). Dopaminergic hypersensitivity and cholinergic hypofunction in the pathophysiology of tardive dyskinesia. Psychopharmacologia (Berl.), 34, 21–35

    Article  CAS  Google Scholar 

  • Gilbert, M. M. (1969). Haloperidol in severe facial dyskinesia. Dis. Nerv. Syst., 30, 481–482

    CAS  PubMed  Google Scholar 

  • Godwin-Austin, R. B. and Clark, T. (1971). Persistent phenothiazine dyskinesia treated with tetrabenazine. Br. med. J., 4, 25–26

    Article  Google Scholar 

  • Goldman, D. (1976). Treatment of phenothiazine-induced dyskinesia. Psychopharmacology, 47, 271–272

    Article  CAS  PubMed  Google Scholar 

  • Greenblatt, D. L., Shader, R. I. and DiMascio, A. (1970). Extra-pyramidal effects. In Psychotropic Drug Side Effects (Ed. R. I. Shader and A. DiMascio) Williams and Wilkins Co., Baltimore, pp. 92–106

    Google Scholar 

  • Growden, J. H., Hirsch, M. J., Wurtman, R. J. and Wiener, W. (1977). Oral choline administration to patients with tardive dyskinesia. New Engl. J. Med., 297, 524–5277

    Article  Google Scholar 

  • Guilleminault, C., Tharp, B. R. and Cousin, D. (1973). HVA+5HIAA CSF measurements and 5HTP trials in some patients with involuntary movements. J. neurol. Sei., 18, 435–441

    Article  CAS  Google Scholar 

  • Haddenbrock, S. (1964). Hyperkinetische Dauersyndrome nach hochdosierter und lang Streckerbehandlung mit Neuroleptika. In Begreiterscheinungen und Misserfolge der Psychiatrischen Pharmakotherapie (Ed. H. Kranz and K. Heinrich ), Georg Thieme, Stuttgart, pp. 54–63

    Google Scholar 

  • Hirsch, M. J., Growdon, J. H. and Wurtman, R. J. (1977). Oral choline administration to patients with tardive dyskinesia. Meeting of American Academy of Neurology

    Google Scholar 

  • Hunter, R., Earl, C. J. and Thornicroft, S. (1964). An apparently irreversible syndrome of abnormal movements following phenothiazine medication. Proc. R. Soc. Med., 57, 758–762

    PubMed Central  CAS  PubMed  Google Scholar 

  • Joyston-Bechal, M. P. (1965). Persistent oral dyskinesia in treatment with phenothiazine derivatives. Lancet, i, 600–601

    Article  Google Scholar 

  • Jus, A., Pineau, R., Lachance, R., Pelchat, G., Jus, K., Pires, P. and Villeneuve, R. (1976a). Epidemiology of tardive dyskinesia, Part I. Dis. Nerv. Syst., May, 210–214

    Google Scholar 

  • Jus, A., Pineau, R., Lachance, R., Pelchat, G., Jus, K., Pires, P. and Villeneuve, R. (1976b). Epidemiology of tardive dyskinesia, Part II. Dis. Nerv. Syst., May, 257–261

    Google Scholar 

  • Jus, A., Gautier, J., Villeneuve, A., Jus, K., Pires, P. and Gagnon-Binette, M. (1977). Chronology of combined neuroleptic and antiparkinsonian administration. Am. J. Psychiat., 134, 11–57

    Article  Google Scholar 

  • Jus, K., Jus, A. and Villeneuve, A. (1973). Polygraphic profile of oral tardive dyskinesia and of rabbit syndrome for quantitative and qualitative evaluation. Dis. Nerv. Syst., 34, 27–32

    CAS  PubMed  Google Scholar 

  • Kazamatsuri, H., Chien, C. and Cole, J. O. (1972a). Treatment of tardive dyskinesia I. Clinical efficacy of a dopamine depleting agent tetrabenazine. Archs gen. Psychiat., 27, 95–99

    Article  CAS  Google Scholar 

  • Kazamatsuri, H., Chien, C. and Cole, J. O. (1972b). Treatment of tardive dyskinesia II. Short term efficacy of dopamine-blocking agents haloperidol and thiopropazate. Archs gen. Psychiat., 27, 100–103

    Article  CAS  Google Scholar 

  • Kazamatsuri, H., Chien, C. and Cole, J. O. (1972c). Treatment of tardive dyskinesia III. Clinical efficacy of a dopamine competing agent, methyl dopa. Archs gen. Psychiat., 27, 824–827

    Article  CAS  Google Scholar 

  • Kazamatsuri, H., Chien, C. and Cole, J.O. (1973). Long-term treatment of tardive dyskinesia with haloperidol and tetrabenazine. Am. J. Psychiat., 130, 479–483

    CAS  PubMed  Google Scholar 

  • Kennedy, P. F. (1969). Chorea and phenothiazines. Br. J. Psychiat., 115, 103–104

    Article  CAS  Google Scholar 

  • Klawans, H. L. Jr. (1973a). The pharmacology of tardive dyskinesias. Am. J. Psychiat., 130, 82–86

    Article  PubMed  Google Scholar 

  • Klawans, H. L. Jr. (1973b). The pharmacology of extrapyramidal movement disorders. Monogr. nurol. Sci., 2, 1–136

    Google Scholar 

  • Klawans, H. L. and Rubovits, R. (1974). Effect of cholinergic and anticholinergic agents on tardive dyskinesia. J. Neurol. Neurosurg. Psychiat., 37, 941–947

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Klett, C.J., Point, P. and Caffrey, E. (1972). Evaluating the long term need for antiparkinson drugs by chronic schizophrenics. Archs gen. Psychiat., 26, 374–379

    Article  CAS  Google Scholar 

  • Kobayashi, R. M. (1976). Orofacial dyskinesia—clinical features, mechanisms and drug therapy. West J. Med., 125, 277–288

    PubMed Central  CAS  PubMed  Google Scholar 

  • Korsgaard, S. (1976). Baclofen (Lioresal) in the treatment of neuroleptic induced tardive dyskinesia. Acta psychiat. scand., 54, 17–24

    Article  CAS  PubMed  Google Scholar 

  • Kumar, B. B. (1976). Treatment of tardive dyskinesia with deanol. Am. J. Psychiat., 133, 978

    Article  Google Scholar 

  • Kunin, R. A. (1976). Manganese and niacin in the treatment of drug-induced dyskinesias. J. Orthnomoleculat. Psychiat., 5, 4–27

    Google Scholar 

  • Linden,D. (1977). Treatment of dyskinesia. New Engl. J. Med., 296(17), 1004–1005

    Google Scholar 

  • Linnoila, M., Viukari, M. and Hietala, O. (1976). Effect of sodium valproate on TD. Br. J. Psychiat., 129, 114–119

    Article  CAS  Google Scholar 

  • McCallum, W. A. G. (1970). Tetrabenazine for extra-pyramidal movement disorders. Br. J. Med., 1, 760

    Article  Google Scholar 

  • Mehta, D., Mehta, S. and Mathew, P. (1976). Failure of deanol in treating tardive dyskinesia. Am. J. Psychiat., 133, 1467

    Article  CAS  PubMed  Google Scholar 

  • Merren, M. D. (1972). Amantidine tri tardive dyskinesia. New Engl. J. Med., 286, 268

    CAS  PubMed  Google Scholar 

  • Miller, E. M. (1974). Deanol: a solution for tardive dyskinesia. New Engl. J. Med., 291, 796–797

    CAS  PubMed  Google Scholar 

  • Nashold, B. S. (1969). The effects of central tegmental lesions on tardive dyskinesia. In Psychotropic Drugs and Dysfunctions of the Basal Ganglia (Ed. Crane and Gardner Jr.), Public Health Service Publication, Washington D.C., pp. 111–113

    Google Scholar 

  • O’Flanagan, P. M. (1975). Clonazepam in the treatment of drug induced dyskinesia. Br. Med. J., 1, 269–270

    Article  PubMed Central  PubMed  Google Scholar 

  • Pakkenberg, H. and Fog, R. (1974). Spontaneous oral dyskinesia: results of treatment with tetrabenazine, pimozide, or both. Archs Neurol., 31, 352–353

    Article  CAS  Google Scholar 

  • Paulson, G. W. (1971). Use of pyridoxine in chorea. Am. J. Psychiat., 127, 1091

    Article  CAS  PubMed  Google Scholar 

  • Paulson, G. W. (1975). Tardive dyskinesia. A. Rev. Med., 26, 75–81

    Article  CAS  Google Scholar 

  • Pearce, J. (1971). Mechanism of action of amantidine. Br. med. J., 3, 529

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Prange, A. J., Wilson,I. C., Morris, C. E. (1973). Preliminary experience with tryptophan and lithium in the treatment of tardive dyskinesia. Psychopharmac. Bull., 9, 36–37

    Google Scholar 

  • Pryce, I. J. and Edwards, H. (1966). Persistent oral dyskinesia in female mental hospital patients. Br. J. Psychiat. 112 983–987

    Article  CAS  Google Scholar 

  • Quitkin, F., Rifkin, A., Gochfeld, L. and Klein, D. F. (1977). Tardive dyskinesia: are the first signs reversible? Am. J. Psychiat., 134 (1), 84–87

    Article  CAS  PubMed  Google Scholar 

  • Reda, F. A., Scanlan, J.M., Kemp, K. and Escobar,J. I. (1974). Treatment of tardive dyskinesia with lithium carbonate. New Engl. J. Med., 291, 850

    CAS  PubMed  Google Scholar 

  • Rosin, A. J. and Exton-Smith, A. M. (1965). Persistent oral dyskinesia in treatment with phenothiazine derivatives. Lancet, i, 651

    Google Scholar 

  • Roxburgh, P. A. (1970). Treatment of persistent phenothiazine induced oral dyskinesia. Br. J. Psychiat., 116, 277–280

    Article  CAS  Google Scholar 

  • Sato, S., Daly, R. and Peters, H. (1971). Reserpine therapy of phenothiazine induced dyskinesia. Dis. Nerv. Syst., 32, 680–685

    CAS  PubMed  Google Scholar 

  • Schmidt, W. R. and Jarcho, L. W. (1966). Persistent dyskinesia following phenothiazine therapy. Archs Neurol., 14, 369–377

    Article  CAS  Google Scholar 

  • Schonecker, M. (1957). Ein eigentumliches Syndrom in ovalen Bereich bei Megaphen Applikation. Nervenarzt, 28, 35–42

    Google Scholar 

  • Sedman, G. (1976). Clonazepam in treatment of tardive oral dyskinesia. Br. med. J., 2, 583

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Simpson, G. M., Branchey, M. H., Lee, J. H. et al. (1976). Lithium in tardive dyskinesia. Pharmakopsychologis, 9, 76–80

    Article  CAS  Google Scholar 

  • Simpson, G. M. and Varga, E. (1974). Clozapine— a new antipsychotic agent. Curr. ther. Res., 16, 679–686

    CAS  PubMed  Google Scholar 

  • Singer, R. and Cheng, M. N. (1971). Thiopropazate hydrochloride in persistent dyskinesia. Br. med. J., 4, 22–25

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  • Singh, M. M. (1976). Diazepam in the treatment of tardive dyskinesia. Int. Pharmaco Psychiat., 11, 232–234

    CAS  Google Scholar 

  • Sutcher, H. D., Underwood, R. B., Beatty, R. A. et al, (1971). Orofacial dyskinesia, a dental dimension. J. Am. med. Ass., 216, 1459–1463

    Article  CAS  Google Scholar 

  • Tamminga, C. A., Smith,R.C., Ericksen, S. E., Chang, S., Davis, J. M. (1977). Cholinergic influences in tardive dyskinesia. Am. J. Psychiat. 134(7) 769–774

    Article  CAS  PubMed  Google Scholar 

  • Tarsy, D., Leopold, N. and Sax, D. S. (1974). Physostigmine in choreiform movement disorders. Neurology, 24, 28–33

    Article  CAS  PubMed  Google Scholar 

  • Uhrbrand, L. and Faurbye, A. (1960). Reversible and irreversible dyskinesia after treatment with perphenazine, chlorpromazine, reserpine and ECT. Psychopharmacologia, 1, 408–418

    Article  Google Scholar 

  • Vale, S. and Espejel, M. A. (1971). Amantidine for dyskinesia tarda. New Engl. J. Med., 284, 673

    CAS  PubMed  Google Scholar 

  • Villeneuve, A. and Böszörmenyi, Z. (1970a). Treatment of drug induced dyskinesias. Lancet, i, 353–354

    Article  Google Scholar 

  • Villeneuve, A., Böszörmenyi, Z., Dechambault, M., et al. (1970b). Tentative de traitment de dyskinesia post-neuroleptique de type permanent. Laval Med., 41, 923–933

    CAS  PubMed  Google Scholar 

  • Vinkari, M. and Linnoila, M. (1975). Effect of methyl dopa on tardive dyskinesia in psychogeriatric patients. Curr. ther. Res., 18 (3), 417–424

    Google Scholar 

  • Wertheimer, J. (1965). Syndromes extra-pyramidaux permanents consecutifs a l’administration prolongée de neuroleptiques. Schweiz. Arch. Neurol. Neurochir. Psychiat., 95, 120–173

    Google Scholar 

  • Widroe, H. J. and Heisler, S. (1976). Treatment of tardive dyskinesia. Dis. Nerv. Syst., March, 162–164

    Google Scholar 

  • Wurtman, R. J., Hirsch, M. J. and Growdon, J. H. (1977). Lecithin consumption raises serum free choline levels. Lancet, ii, 68–69

    Article  Google Scholar 

Download references

Authors
  1. Thomas Barnes
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tim Kidger
    View author publications

    You can also search for this author in PubMed Google Scholar

Copyright information

© 1979 Raghu N. Gaind and Barbara L. Hudson

About this chapter

Cite this chapter

Barnes, T., Kidger, T. (1979). Tardive Dyskinesia and Problems of Assessment. In: Current Themes in Psychiatry 2. Palgrave Macmillan, London. https://doi.org/10.1007/978-1-349-04494-8_12

Download citation

  • DOI: https://doi.org/10.1007/978-1-349-04494-8_12

  • Publisher Name: Palgrave Macmillan, London

  • Print ISBN: 978-1-349-04496-2

  • Online ISBN: 978-1-349-04494-8

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation