A 23-year-old man is evaluated in the emergency department because of the acute onset of uncontrolled head turning to one side and tongue protrusion.

Subject
Medicine
System
Nervous System

Kathryn

Member
Jul 29, 2020
670
1
18
Singapore
Country flag
#june2020mccqe1

A 23-year-old man is evaluated in the emergency department because of the acute onset of uncontrolled head turning to one side and tongue protrusion. He was recently diagnosed with schizophrenia and had haloperidol treatment started 3 days ago. He has no other medical problems and takes no additional medications. On examination, he appears anxious; temperature is normal, blood pressure is 140/80 mm Hg, pulse rate is 100/min, and respiration rate is 14/min. His head is turned 40 degrees to the right, and he has sustained tongue protrusion. He is unable to turn his head back to midline or retract his tongue back into his mouth. The remainder of his neurologic examination is normal. Which of the following is the most likely diagnosis?
(A) Drug-induced dystonia
(B) Huntington disease
(C) Idiopathic cervical dystonia
(D) Neuroleptic malignant syndrome
 
Last edited by a moderator: