Other acute movement disorders include dyskinesias, stereotyped behaviors in response to neuroleptics, and tics, which may occur in response to such CNS stimulants as methylphenidate, dextroamphetamine, and pemoline. Akathisia is a state of motor restlessness that involves an irresistible need to move. Movement tends to alleviate the symptoms temporarily. The restlessness is thought to be mediated by mesolimbic dopamine receptor blockade. Symptomatically, this may be related to restless legs syndrome.
Therapy consists of removing the offending agent.
When this is not possible, symptoms can be alleviated with benzodiazepines, anticholinergics, beta blockers, and, in some cases, dopamine agonists. In a fully developed case, a person may experience head nodding, pelvic rocking, and fine movements of the fingers and toes. In rare instances, TD can affect the diaphragm and cause respiratory distress. Patients with tardive dystonia present with axial dystonic contractions more often than with appendicular dystonic contractions. Other tardive syndromes include tardive akathisia, tardive tics, and even tardive tremor.