A 40-year-old man on haloperidol for schizophrenia develops sustained upward deviation of the eyes with neck stiffness within 2 days of starting therapy. This acute reaction is best described as:
- A Tardive dyskinesia
- B Oculogyric crisis — a form of acute dystonia ✓
- C Neuroleptic malignant syndrome
- D Akathisia
Correct answer: B. Oculogyric crisis — a form of acute dystonia
Explanation
Oculogyric crisis is a type of acute dystonia characterised by sustained involuntary upward or lateral deviation of the eyes, typically occurring within hours to days of starting a dopamine D2 antagonist such as haloperidol. It results from dopaminergic-cholinergic imbalance in the basal ganglia and responds promptly to anticholinergic drugs (e.g., benztropine or promethazine IV). Tardive dyskinesia appears after months/years, while NMS presents with hyperthermia and rigidity.
Reference: KD Tripathi, Essentials of Medical Pharmacology, 8th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.