A 60-Year-Old Woman Comes to the Office Due to Uncontrollable

A 60-year-old woman comes to the office due to uncontrollable movements that have worsened.  Medical history is significant for hypertension, hyperlipidemia, osteoarthritis, and schizophrenia, and she has been on a stable medication regimen for years.  Throughout the interview, she exhibits facial grimacing, lip smacking, and twisting movements of her hands and feet.  The patient has lived in a group home for many years and worries that her housemates are avoiding her because her symptoms make her look "strange."  On mental status examination, the patient makes poor eye contact and is generally distrustful but has no specific delusions or hallucinations.  Which of the following is the most likely diagnosis?

A) Acute dystonia
B) Acute psychotic episode
C) Akathisia
D) Neuroleptic-induced parkinsonism
E) Neuroleptic malignant syndrome
F) Tardive dyskinesia
G) Tic disorder

Correct Answer:

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