Which set of symptoms defines acute pseudoparkinsonism?

• A. Resting tremor and bradykinesia only
• B. Slurred speech and ataxia
• C. Bradykinesia with bradyphrenia
• D. Pill-rolling tremor, cogwheel rigidity, bradykinesia

Answer: (D)

Acute pseudoparkinsonism is a drug-induced parkinsonian syndrome caused by dopamine blockade in the nigrostriatal pathway, leading to the classic parkinsonian motor signs appearing quickly after exposure. The defining set includes a resting tremor (often described as pill-rolling), rigidity that produces a cogwheel sensation when the limb is moved, and slowed movements (bradykinesia). This combination best captures the motor impact of dopamine blockade and distinguishes it from other movement problems.

The other options don’t fit the full picture: resting tremor with bradykinesia alone omits rigidity; slurred speech and ataxia point to cerebellar issues rather than parkinsonism; bradykinesia with bradyphrenia adds cognitive slowing rather than a motor triad.