Tardive Akathisia with Asymmetric and Upper-body Presentation: Report of Two Cases and Literature Review

Background: Akathisia is an inner urge to move a body area with an objective motor component of restlessness. Tardive akathisia (TA) is usually bilateral with a predominant lower-body presentation. We report two patients with an asymmetrical predominantly upper-body involvement.

Case Report: Two young men with history of psychiatric problems and neuroleptic use revealed atypical TA, characterized by asymmetrical and predominantly upper-body involvement. Their main manifestations were rubbing the face, mostly with one hand, accompanied by an inner sensation of restlessness.

Discussion: Our patients are proof that TA can present with asymmetrical and upper-body involvement even with normal brain imaging.