A 30 year old manic patient was prescribed haloperidol one week back. For the last two days, he has become restless and kept pacing in the room for a day. On examination, he was found to have tremors of hand. He is most likely suffering from –
**Core Concept**
Haloperidol, a typical antipsychotic medication, can cause extrapyramidal side effects (EPS) due to its blockade of dopamine D2 receptors in the nigrostriatal pathway, leading to an imbalance in motor control.
**Why the Correct Answer is Right**
The patient's symptoms of restlessness, pacing, and hand tremors are indicative of akathisia, a type of EPS characterized by subjective feelings of restlessness and objective signs of agitation. This condition is a result of the blockade of dopamine D2 receptors in the brain, particularly in the mesolimbic pathway, which is involved in motor control. The nigrostriatal pathway, which is responsible for regulating movement, is also affected, leading to the development of extrapyramidal symptoms.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is not provided. Please check the question for the complete options.
**Option B:** If the patient was suffering from tardive dyskinesia, he would exhibit involuntary, repetitive movements of the face and limbs, which is not the case here.
**Option C:** Dystonia is a type of EPS characterized by involuntary muscle contractions, leading to abnormal postures. While the patient is experiencing restlessness and tremors, the symptoms do not fit the classic presentation of dystonia.
**Option D:** This option is not provided. Please check the question for the complete options.
**Clinical Pearl / High-Yield Fact**
Remember that akathisia is a common side effect of antipsychotic medications, particularly typical antipsychotics like haloperidol, and can be distinguished from other EPS by its characteristic subjective feelings of restlessness and objective signs of agitation.
**Correct Answer: C. Dystonia is a type of EPS characterized by involuntary muscle contractions, leading to abnormal postures. While the patient is experiencing restlessness and tremors, the symptoms do not fit the classic presentation of dystonia.