PsychRounds: The Psychiatry Podcast Extrapyramidal Symptoms (EPS)
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Dec 11, 2024 Dive into the intriguing world of extrapyramidal symptoms tied to antipsychotic medications. Discover the complexities of acute dystonia and its effective treatment strategies. Unravel the neurological mechanics behind symptoms like akathisia and tardive dyskinesia, and explore promising new treatment options. Understand the critical balance of cholinergic and dopaminergic systems, emphasizing the necessity for early recognition and cautious long-term management of these conditions.
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Neuroscience of EPS
- The basal nuclei motor output is controlled by a balance of cholinergic excitation and dopamine inhibition.
- Understanding this balance clarifies EPS pathophysiology and treatment.
Drug-Induced Parkinsonism
- Drug-induced Parkinsonism presents with symptoms like rigidity, tremor, shuffling gait, and bradykinesia.
- Treat with benztropine, but avoid long-term use and don't start it prophylactically.
Acute Dystonia
- Acute dystonia involves sustained muscle contractions, often in the neck, face, or back, and can be life-threatening.
- Treat with benztropine or diphenhydramine intramuscularly or intravenously.