Diagnosis information

Tardive dystonia & tardive akathisia

Core diagnostic criteria, specifiers, differential considerations, and documentation support in one open, scan-friendly view.

G24.09Medication-Induced MovementLocal clinical reference

Criteria: 2 criteria, A–B
Specifiers: 7 specifiers
Differentials: 5 considerations
Severity specifier: Supported

Core diagnostic criteria

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A
Core criterion A
Involuntary movements (tardive dystonia: sustained/repetitive muscle contractions; tardive akathisia: subjective restlessness + repetitive movements) developing in association with neuroleptic use, persisting ≥4 weeks
B
Core criterion B
Movements persist after neuroleptic dose reduction or discontinuation; or neuroleptic still required and symptoms are persistent

Specifiers

Tardive dystonia - predominantly cervical: Dystonic posturing centred on neck muscles (e.g. torticollis, retrocollis).
Tardive dystonia - predominantly cranial: Dystonia involving eyelids, jaw, tongue, or facial musculature.
Tardive dystonia - generalised: Widespread dystonia involving multiple major body regions.
Tardive akathisia - predominantly subjective: Internal agitation prominent, with minimal observable movement.
Tardive akathisia - predominantly objective: Observable motor restlessness prominent.
Mild / Moderate / Severe: Based on degree of restlessness or dystonia and functional impairment.
In remission: Symptoms have substantially resolved.

Documentation support

Consistent with [Tardive Dystonia / Tardive Akathisia] [specifier(s)]. Following prolonged exposure to a dopamine receptor-blocking agent, there have been sustained muscle contractions; abnormal posturing; twisting or torsional movements; repetitive patterned movements (tardive dystonia), and/or marked inner restlessness; an urge to move; pacing; an inability to remain still; shifting weight; repetitive leg movements (tardive akathisia), forming a pattern consistent with a persistent medication-induced tardive syndrome. The presentation is further characterised by symptom onset or persistence for at least several weeks after dose reduction or cessation, and a chronic or fluctuating course distinct from acute syndromes. These symptoms have resulted in clinically significant distress or impairment, and are not better explained by anxiety disorders, agitation from mood or psychotic episodes, substance intoxication or withdrawal, or primary movement disorders.

Adapt this supplied template to the assessment. It is not a substitute for diagnostic reasoning or local documentation requirements.

DSM-5 DiagnosisDSM-mim-tardive-dystonia-tardive-akathisiaSupplied local catalogue