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Tardive dyskinesia — SCE Neurology MCQ

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HardMovement DisordersTardive dyskinesiaSCE Neurology

A 61-year-old woman with bipolar disorder develops repetitive lip-smacking, tongue protrusion and choreiform finger movements. She has taken haloperidol for 4 years. The movements persist during distraction and started after months of exposure. Parkinsonism is minimal. What is the most likely diagnosis?

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Correct answer: B — Tardive dyskinesia

Tardive dyskinesia is the best answer. Chronic dopamine-receptor blocker exposure with oro-bucco-lingual stereotypies and choreiform movements indicates tardive dyskinesia. Acute dystonia occurs soon after exposure; akathisia is inner restlessness; Sydenham chorea follows streptococcal illness in younger patients; myoclonus is jerk-like rather than stereotyped. Clinical pearl: Tardive syndromes may persist after drug withdrawal, so prevention and early recognition matter.

Reference: BNF; NICE antipsychotic prescribing guidance