Extrapyramidal Symptoms (EPS)

Summary

Extrapyramidal symptoms, abbreviated EPS, are most commonly caused as a side effect of antipsychotics and antiemetics.

They are a group of movement disorders that include acute dystonia, parkinsonism, akathisia, and tardive dyskinesia.

The anticholinergic medication benztropine is a common treatment for EPS.

Key Points

• Extrapyramidal Symptoms (EPS)
  • Manifestations
    • Acute Dystonia
      • Involuntary eye movement
      • Muscle spasms
        • Tongue, neck, face, and back
    • Parkinsonism
      • Tremors
      • Muscle rigidity
      • Shuffling gait
    • Akathisia
      • Restlessness
    • Tardive Dyskinesia (TD)
      • Involuntary face and tongue movement
        • Tongue protrusion/rolling
        • Lip smacking
      • A late extrapyramidal symptom that occurs months to years after starting treatment
  • Causes
    • Antipsychotics
      • Typical antipsychotics are the most common cause of EPS
    • Antiemetics
      • Including ondansetron and metoclopramide
  • Treatment
    • Benztropine
      • An anticholinergic medication