Question:
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
Step 1: Note the time frame. Symptoms began only 2 days after starting haloperidol, a high-potency typical antipsychotic with strong dopamine D2 blockade.
Step 2: Match the clinical picture. Torticollis, abnormal sustained postures and orofaciolingual (tongue, face) spasms within hours to a few days of starting the drug are classic for acute dystonia.
Step 3: Exclude tardive dyskinesia. That appears after months to years of antipsychotic use, not within 2 days, so it is wrong here.
Step 4: Exclude parkinsonism (rigidity, bradykinesia, tremor; develops over weeks) and akathisia (subjective inner restlessness with inability to sit still). Neither fits acute sustained muscle spasms.
Step 5: Recall treatment. Acute dystonia responds rapidly to parenteral anticholinergics such as benztropine or the antihistamine promethazine.
Answer: Option A, Acute dystonia.
Step 2: Match the clinical picture. Torticollis, abnormal sustained postures and orofaciolingual (tongue, face) spasms within hours to a few days of starting the drug are classic for acute dystonia.
Step 3: Exclude tardive dyskinesia. That appears after months to years of antipsychotic use, not within 2 days, so it is wrong here.
Step 4: Exclude parkinsonism (rigidity, bradykinesia, tremor; develops over weeks) and akathisia (subjective inner restlessness with inability to sit still). Neither fits acute sustained muscle spasms.
Step 5: Recall treatment. Acute dystonia responds rapidly to parenteral anticholinergics such as benztropine or the antihistamine promethazine.
Answer: Option A, Acute dystonia.
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