Identification

• The extrapyramidal motor system is a neural network in the brain involved in the coordination of movement. Extrapyramidal side effects are involuntary movements that first appear in the early stages of treatment.
  
  

Reversible Effects

• Extrapyramidal symptoms typically are reversible if the medication is discontinued. In contrast, when these side effects first appear later during treatment, they are called tardive dyskinesia or dystonia, and often are permanent.
  
  

Body Movements

• The involuntary movements can include disorganized walking, such as a stumbling or clumsy gait. The patient may have odd finger movements, muscle rigidity, muscle spasms and tremors. He might occasionally kick a leg outward or raise an arm in the air.
  
  

Facial Effects

• Often, facial and tongue effects are the first to appear. Uncontrollable facial movements include chewing, eye blinking, grimacing, repetitive swallowing, slurred speech and the tongue probing the cheek.
  
  

Subtle vs. Obvious

• Extrapyramidal side effects can be so subtle that the doctor may not even notice them. In contrast, the effects can also be obvious and bizarre, to the point of causing difficulty in social interactions and in the workplace.