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Tremors, fever, tachycardia, and "lead pipe" rigidity
0%
0/8
Involuntary writhing of the face, tongue, or head
50%
4/8
Cogwheel rigidity, masked facies, and bradykinesia
Restlessness, agitation, and fidgetiness
Sustained contraction of muscles of neck, tongue, eyes
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This phrase is a description of tardive dyskinesia (TD). Antipsychotic medications have a side effect profile known as extrapyramidal symptoms (EPS) including TD, dystonia, parkinsonism, and akathisia. The various movement disorders known as EPS are mainly due to the action of antipsychotic medications blocking dopamine receptors. EPS are most likely seen with the first-generation (typical) antipsychotic medication, haloperidol. Unlike the other symptoms of EPS, TD may persist after withdrawal of the drug for months, years or even permanently. TD can be characterized by involuntary perioral movements, such as lip smacking, grimacing, tongue protrusions, and biting. TD occurs most commonly in patients treated with antipsychotic medications for many years. TD must not be misdiagnosed as a mental illness or a neurological disorder. Misdiagnosis could result in the patient being prescribed more neuroleptic medications, ultimately exacerbating the development of more severe and disabling TD. Granacher describes TD as a movement disorder that tends to evidence itself after an extended use of antipsychotic agents. When TD is diagnosed, the best course of action is to discontinue the causative medication. If this is not possible, the lowest effective dose of the medication should be implemented. Chung reports an atypical presentation of TD associated with the second generation long-acting injectable (LAI) antipsychotic, risperidone. Risperidone LAI has been used in the maintenance treatment of bipolar affective disorder. TD related to antipsychotic use is hypothesized to be due in part to dopaminergic hypersensitivity at the nigrostriatal pathway after chronic dopamine blockade. Although rare, it is essential to closely monitor the potential for TD development in someone receiving risperidone LAI. Illustration A depicts someone experiencing some of the symptoms of TD. Video V shows a women experiencing TD. Incorrect Answers: Answer 1: This phrase describes neuroleptic malignant syndrome. Answer 3: This phrase describes parkinsonism. Answer 4: This phrase describes akathisia. Answer 5: This phrase describes acute dystonia (torticollis=neck, oculogyric crisis=eyes).
4.7
(3)
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