Question:easy
A schizophrenic patient started on haloperidol 2 days back comes with complaints of torticollis and orofaciolingual movements. What is the diagnosis?
A schizophrenic patient started on haloperidol 2 days back comes with complaints of torticollis and orofaciolingual movements. What is the diagnosis?
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Sustained spasms within 2 days of a high-potency antipsychotic point to which reaction?
Updated On: Jun 24, 2026
- Acute dystonia
- Tardive dyskinesia
- Parkinsonism
- Akathisia
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The Correct Option is A
Solution and Explanation
Extrapyramidal side effects of antipsychotics each have a characteristic timeline, and the timeline is the fastest way to crack this question.
The patient has been on haloperidol, a potent D2 blocker, for only two days, and presents with torticollis plus involuntary tongue and facial movements. Reactions that come on within hours to a few days, featuring sudden sustained muscle contractions, abnormal neck posturing, eye rolling or tongue protrusion, define acute dystonia. It is more common in young males and high-potency agents, exactly the setting described.
The distractors are separated by their own time courses and features. Tardive dyskinesia produces repetitive orofacial movements too, but only after prolonged treatment over many months to years, so a two-day history rules it out. Drug-induced parkinsonism evolves over weeks with rigidity, slowness and tremor. Akathisia is a distressing sense of restlessness that drives constant movement rather than fixed dystonic postures. The acute onset with sustained spasm points firmly to acute dystonia, which is reversed quickly by intramuscular anticholinergics.
\[\boxed{\text{Acute dystonia}}\]
The patient has been on haloperidol, a potent D2 blocker, for only two days, and presents with torticollis plus involuntary tongue and facial movements. Reactions that come on within hours to a few days, featuring sudden sustained muscle contractions, abnormal neck posturing, eye rolling or tongue protrusion, define acute dystonia. It is more common in young males and high-potency agents, exactly the setting described.
The distractors are separated by their own time courses and features. Tardive dyskinesia produces repetitive orofacial movements too, but only after prolonged treatment over many months to years, so a two-day history rules it out. Drug-induced parkinsonism evolves over weeks with rigidity, slowness and tremor. Akathisia is a distressing sense of restlessness that drives constant movement rather than fixed dystonic postures. The acute onset with sustained spasm points firmly to acute dystonia, which is reversed quickly by intramuscular anticholinergics.
\[\boxed{\text{Acute dystonia}}\]
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