Rapoport A, Stein D, Grinshpoon A, Elizur A
Department of Neurology, E. Wolfson Medical Center, Holon, Israel.
J Clin Psychiatry. 1994 Nov;55(11):473-7.
Akathisia is a common side effect of neuroleptic treatment that is diagnosed on the basis of clinical observations. Its definition is regarded as complex and controversial. Thus, for example, while some authorities see akathisia as strictly an abnormal subjective state, others require the inclusion of specific repetitive movements. The present study suggests that the addition of objective accelerometric recordings to standardized clinical observations may increase the validity of this diagnosis.
Sixteen chronic schizophrenic patients, treated with various neuroleptic medications, were diagnosed as suffering from akathisia. The diagnosis was based on detailed clinical observations performed according to accepted diagnostic criteria. All patients underwent repeated accelerometric recordings following the onset of akathisia.
While most subjects suffered from lower limb akathisia, 5 patients demonstrated the involvement of other body segments. Akathisia most frequently appeared while the patients were seated. The abnormal movements were regular, nonparoxysmal, and intermittent. Most patients suffered from a tardive disorder. The accelerometric recordings demonstrated in all cases a constant and regular wave form, frequency (below 4 Hz), and amplitude. The findings were reproducible, i.e., similar patterns appeared in several recordings of the same patient during the abnormal movements.
Extensive and detailed clinical evaluations reveal that akathisia is not necessarily associated with restless pacing. Rather, the syndrome may include periodic, regular, and stereotyped movements, appearing in different body segments. Accelerometric recordings seem to confirm the clinical diagnosis of akathisia, demonstrating the existence of a constant wave form, frequency, and amplitude. In addition, these techniques may distinguish between akathisia and other disorders e.g., neuroleptic-induced tremor or tardive dyskinesia.
静坐不能是抗精神病药物治疗常见的副作用，其诊断基于临床观察。其定义被认为复杂且有争议。例如，一些权威认为静坐不能严格来说是一种异常的主观状态，而另一些则要求包括特定的重复性动作。本研究表明，在标准化临床观察中加入客观的加速度记录可能会提高该诊断的准确性。
16名接受各种抗精神病药物治疗的慢性精神分裂症患者被诊断为患有静坐不能。诊断基于按照公认诊断标准进行的详细临床观察。所有患者在静坐不能发作后均接受了重复的加速度记录。
虽然大多数受试者患有下肢静坐不能，但有5名患者表现出身体其他部位也受累。静坐不能最常出现在患者坐着的时候。异常动作是规律的、非阵发性的和间歇性的。大多数患者患有迟发性障碍。加速度记录在所有病例中均显示出恒定且规律的波形、频率（低于4赫兹）和振幅。这些发现具有可重复性，即在同一患者异常动作期间的几次记录中出现了相似的模式。
广泛而详细的临床评估表明，静坐不能不一定与坐立不安的踱步有关。相反，该综合征可能包括出现在不同身体部位的周期性、规律性和刻板动作。加速度记录似乎证实了静坐不能的临床诊断，证明了恒定波形、频率和振幅的存在。此外，这些技术可能有助于区分静坐不能和其他障碍，例如抗精神病药物引起的震颤或迟发性运动障碍。
