Personality and Mood Disorders Q 81

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The client on Haldol has pill rolling tremors and muscle rigidity. He is likely manifesting:

  

     A. Tardive dyskinesia

     B. Pseudoparkinsonism

     C. Akinesia

     D. Dystonia

    

    

Correct Answer: B. Pseudoparkinsonism

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Pseudoparkinsonism is a side effect of antipsychotic drugs characterized by mask-like faces, pill-rolling tremors, muscle rigidity. Patients with this disorder have apraxic slowness, paratonic rigidity, frontal gait disorder, and elements of akinesia that, taken together, may be mistaken for true parkinsonism. Pseudoparkinsonism appears to be common and is most often due to Alzheimer’s disease or vascular dementia.

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Option A: Tardive dyskinesia is manifested by lip-smacking, wormlike movement of the tongue. Tardive dyskinesia (TD) is a syndrome that includes a group of iatrogenic movement disorders caused due to a blockade of dopamine receptors. The movement disorders include akathisia, dystonia, buccolingual stereotypy, myoclonus, chorea, tics, and other abnormal involuntary movements which are commonly caused by the long-term use of typical antipsychotics.

Option C: Akinesia is characterized by a feeling of weakness and muscle fatigue. The term akinesia refers to the inability to perform a clinically perceivable movement. It can present as a delayed response, freezing mid-action, or even total abolition of movement. Akinesia occurs when movement is not perceived either because the amplitude of the movement is small or because the time taken to initiate the reaction is significantly increased.

Option D: Dystonia is manifested by torticollis and rolling back of the eyes. Dystonia is defined by involuntary maintained contraction of agonist and antagonist muscles yielding abnormal posturing, twisting, and repetitive movements or tremulous and can be initiated or worsened by attempted movement.

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