Spontaneous dyskinesia in first episode schizophrenia

In the west London prospective study of first episode schizophrenia, the pr evalence and nature of abnormal involuntary movements were examined in 27 p atients who had never received antipsychotic drugs and 36 who had been trea ted with such medication. Motor disturbance was assessed with rating scales designed to cover the full range of spontaneous and drug induced movement disorder. Only one person in the drug naive group showed evidence of parkin sonism, a finding which contrasts with recent reports suggesting that spont aneous extrapyramidal signs may not be uncommon in such patients. However, according to ratings on the modified Rogers scale, 11% of the drug naive gr oup exhibited orofacial dyskinesia, 4% trunk and limb dyskinesia, 7% postur al abnormalities, and 4% increased muscle tone. The respective figures in t he closely matched medicated group were not significantly different except for increased muscle tone, which was significantly more common (25%). The p roportion of drug naive patients fulfilling criteria for tardive dyskinesia on the abnormal involuntary movements scale ranged from 4% to 11% dependin g on the criterion threshold score used. These findings are in accord with the notion that abnormal involuntary movements, particularly orofacial dysk inesia, represent a neuromotor component of schizophrenia.