Differential Diagnosis for a Woman with Tongue Rolling and Lip Smacking after Taking Anti-Psychotic

• Single Most Likely Diagnosis
  • A. Tardive Dyskinesia: This condition is characterized by involuntary, repetitive body movements that can occur due to long-term use of neuroleptic drugs, such as anti-psychotics. The symptoms described, including tongue rolling and lip smacking, are classic signs of tardive dyskinesia, making it the most likely diagnosis in this scenario.
• Other Likely Diagnoses
  • B. Dystonia: Dystonia involves involuntary muscle contractions, which can lead to repetitive movements or abnormal postures. While dystonia can be a side effect of anti-psychotic medication, the specific symptoms of tongue rolling and lip smacking are more commonly associated with tardive dyskinesia. However, dystonia remains a plausible diagnosis given the context.
  • C. Parkinson's: Although less likely, drug-induced parkinsonism is a possible side effect of anti-psychotic medications. However, the primary symptoms of parkinsonism include tremors, rigidity, bradykinesia, and postural instability, which are different from the symptoms described.
• Do Not Miss Diagnoses
  • None specifically identified in this scenario that would be immediately life-threatening if missed, but it's crucial to consider the potential for severe drug reactions or neurological conditions that could present with similar symptoms.
• Rare Diagnoses
  • Other rare movement disorders could potentially present with similar symptoms, such as Huntington's disease or certain forms of chorea. However, these conditions would typically have additional symptoms and a distinct clinical context that differentiates them from the scenario described.