Diagnosing And Treating Akathisia

Akathisia is a disorder where the patient feels compelled to move at all times. The need is especially urgent in their legs. Individuals who have this condition basically cannot sit still, and this inability gives the illness its name. Patients tap and stomp their feet, fidget, cross, uncross and shuffle their legs, or pace the floor. In many cases, the movement only stops when the patient's legs or feet are too tired to move.

But even when the individual rests, they still feel the compulsion to keep moving. Other akathisia patients feel as if they are going to jump out of their skin or suffer from bouts of panic. Akathisia is often a side effect of medication taken for conditions such as schizophrenia, especially older antipsychotics.

Physical Exam And Rule Out Other Conditions

Not everyone who is afflicted with restlessness has akathisia. Restless leg syndrome, for example, is a disorder where the patient has a nearly uncontrollable compulsion to move their legs. The urge is made worse when the patient lies down and is worse at night when they are trying to sleep. Other conditions that might mimic akathisia are periodic limb movement disorder and tardive dyskinesia, a disorder where the patient is subject to involuntary bodily movements that often involve the face.

A diagnosis of akathisia requires the doctor to note how the patient moves their body, especially their legs and feet, listen to the patient's description of their symptoms, conduct a physical exam, and rule out other conditions. The Barnes Akathisia rating scale helps with the diagnosis and gives the doctor an idea of the severity of the problem.