Akathisia after mild traumatic head injury.
The authors describe the case of a 13-year-old boy who exhibited progressive disabling motor restlessness, torticollis, urinary symptoms, and confusion following a fall from a bicycle. The differential diagnosis of this striking symptom complex in this clinical context can be problematic. In this case, the symptoms ultimately appeared most consistent with severe akathisia resulting from a single administration of haloperidol used at an outside hospital to sedate the patient prior to a head CT scan. The literature on akathisia in pediatric patients, and especially in patients following acute head injury, is reviewed, with suggestions for an approach to these symptoms in this clinical setting.
Desai
Atman
A
Section of Pediatric Surgery (Neurosurgery), Dartmouth-Hitchcock Medical Center, One Medical Center Drive, Lebanon, New Hampshire 03756, USA. atman.desai@hitchcock.org
Nierenberg
David W
DW
Duhaime
Ann-Christine
AC
D000058:Accidental Falls; D000293:Adolescent; D017109:Akathisia, Drug-Induced / Q000175:diagnosis*; D014150:Antipsychotic Agents / Q000008:administration & dosage / Q000009:adverse effects*; D001265:Athletic Injuries / Q000150:complications* / Q000175:diagnosis; D001642:Bicycling / Q000293:injuries*; D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D004359:Drug Therapy, Combination; D015600:Glasgow Coma Scale; D006220:Haloperidol / Q000008:administration & dosage / Q000009:adverse effects*; D016489:Head Injuries, Closed / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D007262:Infusions, Intravenous; D008279:Magnetic Resonance Imaging; D008297:Male; D009460:Neurologic Examination / Q000187:drug effects; D011595:Psychomotor Agitation / Q000175:diagnosis / Q000188:drug therapy*; D014057:Tomography, X-Ray Computed
D014150:Antipsychotic Agents; D006220:Haloperidol