Akathisia after mild traumatic head injury

Area of Science:

• Neuroscience
• Pediatric Neurology
• Clinical Psychiatry

Background:

• Akathisia is a movement disorder characterized by a subjective feeling of inner restlessness and a compelling urge to move.
• It is often associated with antipsychotic medications but can occur with other drugs and conditions.
• Diagnosis can be challenging, particularly in pediatric populations and following acute head injury.

Observation:

• A 13-year-old boy presented with progressive motor restlessness, torticollis, urinary symptoms, and confusion after a bicycle fall.
• Symptoms emerged after receiving haloperidol for sedation prior to a head CT scan at an outside hospital.
• The complex presentation complicated the differential diagnosis in the context of recent head trauma.

Findings:

• The patient's symptoms were ultimately deemed most consistent with severe akathisia.
• This akathisia appeared to be a direct result of a single dose of haloperidol.
• The case underscores the potential for medication-induced movement disorders in adolescents.

Implications:

• This case highlights the importance of considering medication side effects, such as akathisia, in the differential diagnosis of new-onset neurological and psychiatric symptoms in children.
• Accurate and timely diagnosis of akathisia is crucial for appropriate management and to prevent potential complications.
• Further research and clinical awareness are needed regarding akathisia in pediatric patients, especially those with concurrent head injuries.