BOF: 2.45
A 27-year-old female is brought in by her parents. She is
known to be schizophrenic and is on Trifluoperazine for this.
The parents tell you that their daughter seems to be
exceedingly restless and never seems to stay still.
You observe that the patient is seated on a chair but is
continuously crossing and uncrossing her legs and fidgeting with her clothes
and touching her hair.
On examination there is no tremor, the muscle tone is
normal and there is no weakness of her muscles. The rest of the neurological
examination is unremarkable.
The condition the patient has is:
a)
Akathisia
b)
Chorea
c)
Parkinsonism
d)
Tardive dyskinesia
e)
Acute dystonia
Answer:
a)
Akathisia refers to a sensation of restlessness, which
manifests as an inability to stay still (Greek: kathesis sitting a
without hence without sitting)
Chorea is a type of dyskinesia and refers to a dance like
quasi-purposive movement
There are no features of Parkinsonism such as paucity of
movement, tremor or rigidity.
Tardive dyskinesias are late onset purposeless
involuntary movements (lip smacking grimacing)
Acute dystonia causes changes in tone resulting in
conditions such as torticollis, oculogyric crisis
