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Extrapyramidal Side EffectAka: Extrapyramidal Reaction, Akinesia, Dystonic Reaction, Dyskinesia, Akathisia, Tardive Dyskinesia

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  1. Adverse Effects: Reversible Extrapyramidal signs and symptoms
    1. Conditions responsive to anti-Parkinsons Agents
      1. Akinesia (lack of movement, Parkinson-like)
      2. Dystonic Reaction (facial muscle spasm, neck, back)
      3. Dyskinesia (Blinking or twitches)
      4. Akathisia (Can not to sit still, inner restlessness)
      5. Perioral Tremor (Rabbit Syndrome)
    2. Neuroleptic Malignant Syndrome
      1. Presents as catatonia, fever, unstable Blood Pressure
      2. Life-threatening; Stop Antipsychotic immediately
  2. Adverse Effects: Irreversible
    1. Evaluate for these signs monthly while on Antipsychotic
    2. Tardive Dyskinesia
      1. Hyperkinesia (lingual or facial)
        1. Blinking
        2. Lip smacking
        3. Sucking or chewing
        4. Rolls or protrudes Tongue
        5. Grimaces
      2. Choreoathetoid extremity movement
        1. Clonic jerking fingers, ankles, toes
      3. Tonic contractions of neck or back
  3. Management
    1. Reversible Extrapyramidal Effects
      1. Tolerance to affect
      2. Decrease or Increase OR Discontinue drug dose
      3. Shift patient to a non-EPSE side effect
      4. Antihistamine (Benadryl)
    2. Tardive Dyskinesia
      1. Consider Clozapine as alternative Antipsychotic

Dyskinetic syndrome (C0013384)

Definition (MSH)Abnormal involuntary movements which primarily affect the extremities, trunk, or jaw that occur as a manifestation of an underlying disease process. Conditions which feature recurrent or persistent episodes of dyskinesia as a primary manifestation of disease may be referred to as dyskinesia syndromes (see MOVEMENT DISORDERS). Dyskinesias are also a relatively common manifestation of BASAL GANGLIA DISEASES.
Definition (NCI)Difficulty moving; distortion or impairment of voluntary movement, as in tic, spasm, or myoclonus.
Definition (NCI)Difficulty moving; distortion or impairment of voluntary movement, as in tic, spasm, or myoclonus.
ConceptsDisease or Syndrome (T047)
MSHD020820
EnglishAbnormal Movement, Abnormal Movements, Dyscinesia, Dyskinesia, Dyskinesias, Dyskinesis, Dyskinetic syndrome, SYNDROME DYSKINETIC
Spanishcoordinacion anormal, descoordinacion, discinesia, incoordinacion, trastorno de la coordinacion
Parent ConceptsBrain Diseases (C0006111), Movement Disorders (C0026650), Neurologic Manifestations (C0027854), Other Finding (C1335151), Motor dysfunction (C0234131), Ambiguous concept (C1274012), Finding by site (C1290906)
SourcesCOSTAR, CSP, CST, MEDLINEPLUS, MSH, MTH, NCI, NDFRT, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Dyskinesia, Drug-Induced (C0013386)

Definition (MSH)Abnormal movements, including HYPERKINESIS; HYPOKINESIA; TREMOR; and DYSTONIA, associated with the use of certain medications or drugs. Muscles of the face, trunk, neck, and extremities are most commonly affected. Tardive dyskinesia refers to abnormal hyperkinetic movements of the muscles of the face, tongue, and neck associated with the use of neuroleptic agents (see ANTIPSYCHOTIC AGENTS). (Adams et al., Principles of Neurology, 6th ed, p1199)
ConceptsDisease or Syndrome (T047)
MSHD004409
EnglishDrug-induced dyskinesia, Drug-Induced Dyskinesias, DYSKINESIA DRUG IND
Parent ConceptsDrug toxicity (C0013221), Dyskinetic syndrome (C0013384), Neurotoxicity Syndromes (C0235032), Medication-induced movement disorder (C0236834)
SourcesMSH, MTH, NDFRT, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Akinesia (C0085623)

ConceptsDisease or Syndrome (T047)
EnglishAkinesia
Spanishacinesia, aquinesia
Parent ConceptsBrain Diseases (C0006111), Movement Disorders (C0026650), Motor function behavior finding (C0474393)
SourcesCST, DXP, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Neuroleptic-induced acute akathisia (C0236835)

ConceptsDisease or Syndrome (T047)
ICD9333.99
EnglishNeuroleptic-induced acute akathisia
Spanishacatisia aguda inducida por neurolepticos
Parent ConceptsAkathisia, Drug-Induced (C0162550), Medication-induced movement disorder (C0236834), Acute nervous system disorder (C1290841)
SourcesMTHICD9, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


DYSTONIC REACTION (C0541919)

ConceptsFinding (T033)
EnglishDYSTONIC REACTION
SourcesCST
Derived from the NIH UMLS (Unified Medical Language System)


Tardive Dyskinesia (C0686347)

Definition (CSP)iatrogenic extrapyramidal disorder produced by long-term administration of antipsychotic drugs; characterized by oral/lingual/buccal dyskinesias and choreoathetoid movements of the extremities.
ConceptsDisease or Syndrome (T047)
ICD9333.85
EnglishDrug-induced tardive dyskinesia, DYSKINESIA TARDIVE, Tardive dyskinesia, Tardive dyskinesia -RETIRED-, TD - Tardive dyskinesia
Spanishdiscinesia oral tardia - RETIRADO -, discinesia tardia, discinesia tardia medicamentosa
Parent ConceptsExtrapyramidal Disorders (C0015371), Brain Diseases (C0006111), Movement Disorders (C0026650), Dyskinesia, Medication-Induced (C0751088), Reason not stated concept (C1276325), Dyskinesia, Drug-Induced (C0013386)
SourcesCOSTAR, CSP, CST, LCH, MEDLINEPLUS, MTH, MTHICD9, OMIM, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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