Akathisia caused by traumatic brain injury in an adolescent

Abstract

Akathisia is a clinical condition with subjective complaints such as restlessness, mental unease, an urge to move and dysphoria. It is usually caused by basal ganglion diseases and anti-dopaminergic medications. But rarely it may also occur due to traumatic brain injury (TBI). In this case report, a 17-year-old male patient was discussed who developed akathisia after TBI without any neuropsychiatric disorder or psychotropic drug use earlier. The patient was admitted to the child and adolescent psychiatry clinic with constant complaints of motor restlessness. Three weeks ago he was hospitalized with multiple fractures, subarachnoid and epidural hemorrhage, and cerebral edema after a car accident. Risperidone 0,5 mg/day was prescribed for psychomotor agitation. Two days later symptoms got worsened, consequently, the treatment was changed to propranolol 60mg and lorazepam 7,5 mg per day gradually, following the change of diagnosis to akathisia caused by TBI. There was a significant improvement in akathisia symptoms in days. Akathisia treatment was stopped at the end of three weeks without symptoms. Akathisia caused by TBI, which can be easily misdiagnosed as psychomotor agitation or delirium, is an important clinical condition that affects the treatment and the rehabilitation negatively. Therefore, it should be kept in my mind for differential diagnosis and its treatment should not be delayed.