Which symptom is most characteristic of akathisia?

• A. Motor Restlessness
• B. Slouched Posture and Rigid Bradykinesia
• C. Protrusion of the Tongue with Lip Smacking
• D. Resting Tremor

Answer: (A)

Akathisia is defined by an inner sense of restlessness with observable motor activity. The most characteristic sign is motor restlessness—an almost irresistible urge to move, seen as pacing, fidgeting, foot tapping, or constant shifting in a chair. This combination of internal discomfort and external agitation is what makes motor restlessness the best indicator of akathisia, setting it apart from other drug-induced movement disorders.

The other described signs fit different conditions: slouched posture and rigid bradykinesia point to drug-induced parkinsonism, which involves slowed movements and rigidity; protrusion of the tongue with lip smacking is typical of tardive dyskinesia, which involves repetitive oral-facial movements; and resting tremor is also associated with parkinsonism.