A patient who has recently been commenced on antipsychotics is found in bed adopting a strange posture, which of the following would you suspect?
The vast majority of drug induced dystonias occur within a few days of starting antipsychotic treatment (or after a large increase in the drug). Dystonia in this situation may occur in any muscle group but most commonly is seen in the head and neck.
The vast majority of drug induced dystonias occur within a few days of starting antipsychotic treatment (or after a large increase in the drug). Dystonia in this situation may occur in any muscle group but most commonly is seen in the head and neck.
Movement disorders
Movement disorders in psychiatry
The following definitions need to be learnt.
Akinesia - absence, poverty, or loss of control of voluntary muscle movements. This is seen in severe Parkinson's disease.
Bradykinesia - slowness of movement, core symptom in Parkinson's disease along with tremor and rigidity.
Akathesia - subjective feeling of inner restlessness, most often caused by side effect of neuroleptic medication, often manifests as inability to sit still.
Athetosis - continuous stream of slow, flowing, writhing involuntary movements.
Chorea - brief, quasi-purposeful, irregular contractions that are not repetitive or rhythmic, but appear to flow from one muscle to the next.
Dystonia - sustained muscle contractions cause twisting and repetitive movements or abnormal postures.
Dyskinesia - general term referring to problems with voluntary movements and the presence of involuntary movements.
Myoclonus - Sudden involuntary jerks of a muscle or a muscle group. These are not suppressible.
Parkinsonism - syndrome characterized by tremor, rigidity, and bradykinesia.
Tic - sudden, repetitive, non rhythmic, stereotyped motor movement or vocalization involving discrete muscle groups. These are different to myoclonus as they are suppressible.
Tremor - involuntary, rhythmic, alternating movement of one or more body parts.
Hemiballismus - repetitive, but constantly varying, large amplitude involuntary movements of the proximal parts of the limbs
