Video.
Female Patient with “Tardive Dyskinesia Affecting the Hands.”
This patient was referred by her psychiatrist for evaluation and management of “tardive dyskinesia affecting the hands,” which interfered with her activities of daily living. She has a staring expression; repetitive stereotypic movements of the tongue and mouth; and a regular, large amplitude tremor of the hands present at rest and with action. She was on haloperidol for chronic schizophrenia. While the movements of her lower face were typical of tardive dyskinesia, her staring expression with decreasing blinking indicated drug-induced parkinsonism. Recognition of the hand movements as tremor (a term supplied by the patient!), even though present both at rest and with action, was consistent with this diagnosis. Conversion to quetiapine resolved the drug-induced parkinsonism and improved the facial movements.