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S. A. Schneider, MD, et al. - We describe intermittent or sustained severe involuntary tongue protrusion in patients with a dystonic syndrome. Speech, swallowing, and breathing difficulties can be severe enough to be life threatening. Causes include neuroacanthocytosis, pantothenate kinase–associated neurodegeneration, Lesch–Nyhan syndrome, and postanoxic and tardive dystonia

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