A young weight lifter receives IV haloperidol and exhibits eyes deviated sideways. What is the diagnosis and treatment?

The scenario described is indicative of acute dystonia, a common extrapyramidal side effect associated with the use of antipsychotic medications, such as haloperidol. Acute dystonia presents with sustained muscle contractions, abnormal postures, and, in this case, the deviant eye movements (oculogyric crisis). The rapid onset after receiving intravenous haloperidol further substantiates the diagnosis.

Treatment for acute dystonia is effective with anticholinergic medications such as benztropine or antihistamines like diphenhydramine. These agents work by restoring the balance of neurotransmitters in the brain, counteracting the effects of dopamine antagonism caused by the antipsychotic.

Other conditions listed, such as akathisia and tardive dyskinesia, have different clinical presentations and treatment protocols. Akathisia involves a subjective feeling of restlessness and is typically treated with beta-blockers or benzodiazepines. Tardive dyskinesia presents with involuntary, repetitive body movements and requires different management strategies, often including switching to a different class of antipsychotic drugs. Neuroleptic malignant syndrome is a life-threatening condition characterized by severe muscle rigidity, altered mental status, and autonomic instability