benztropine, một loại thuốc kháng cholinergic được sử dụng trong điều trị bệnh Parkinson, có thể có hiệu quả trong điều trị các tác dụng phụ ngoại tháp. Một tác dụng phụ đặc biệt đáng chú ý của các thuốc chống loạn thần là akathisia, được đặc trưng bởi chuyển động bắt buộc của các chi và bồn chồn động cơ | 360 XIII. Neurologic Disorders Answers benztropine another anticholinergic medicine used in the treatment of Parkinson s disease may be effective in treating these extrapyramidal side effects. A particularly notable side effect of antipsychotic medicines is akathisia which is characterized by obligatory movement of the extremities and motor restlessness. Akathisia may respond to the institution of beta-blocking drugs or antiparkinsonian agents but most likely would benefit from a decrease in the dose of the neuroleptic agent. The most common serious side effect of neuroleptic medicines is tardive dyskinesia manifest by involuntary repetitive movements of musculature such as tongue thrusting and lip smacking. Involuntary limb movements and postural dystonia may also be part of this syndrome. While newer antipsychotic medications such as clozapine may have a role to play in the treatment or amelioration of tardive dyskinesia currently the best approach is to lower the dose of the neuroleptic agent. Of course such reductions may not be possible without exacerbation of the underlying thought disorder. XIII-46. The answer is B. Chap. 362 Huntington s chorea which is inherited as an autosomal dominant trait is characterized by dementia and choreiform movements. The motor disorder may include grimacing respiratory spasms speech irregularity and a dancing jangling quality in the gait. Laboratory workup is normal except that atrophy of the caudate nucleus may be seen on a carefully evaluated CT or MRI scan. Through the use of DNA linkage analysis patients can be tested before disease development if this is appropriate from a psychosocial standpoint. The disease-specific gene is located on the short arm of chromosome 4. XIII-47. The answer is D. Chap. 367 Brief paroxysms of severe sharp pains in the face without demonstrable lesions in the jaw teeth or sinuses are called tic douloureux or trigeminal neuralgia. The pain may be brought on by stimuli applied to the face lips or
